Inspection on 01/06/06 for Berkeley House

This inspection was carried out on 1st June 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Berkeley House 19/09/05

Berkeley House 16/05/05

Berkeley House 10/12/04

Berkeley House 17/05/04

Berkeley House 15/04/03

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

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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 Berkeley House Lynsted Lane Lynsted Sittingbourne Kent ME9 0RL Lead Inspector Jo Griffiths Unannounced Inspection 1st June 2006 11:30 Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 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 Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 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. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Berkeley House Address Lynsted Lane Lynsted Sittingbourne Kent ME9 0RL 01795 522540 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) The Regard Partnership Limited Melinda Glover Care Home 23 Category(ies) of Learning disability (23) registration, with number of places Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate one service user over the age of 65 years. Date of last inspection 19th September 2005 Brief Description of the Service: Berkeley House is a registered care home for 23 adults with learning disabilities. It is one of a group of homes owned and managed by The Regard Partnership. The home is situated in the village of Lynsted, roughly one mile south from the A2 at Teynham. The service is provided in three separate listed buildings set in large grounds. The Granary provides accommodation for four service users. The Windmill has five service users. The main house, The Bakery, has current accommodation for twelve service users. The Granary and The Windmill are self-contained and are staffed independently from the main house. Some areas of the grounds are shared by all three homes although The Granary has independent access and an area of dedicated garden. The home has two vehicles that are used as required to provide transport to local services and amenities. Teynham is on a bus route and has a main line railway station. The fees charged for this service range from £739 - £2369 per week. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took place on 1st June 2006 between 11.30am and 5.15pm. The Manager was present and gave feedback on the progress made since the last inspection. A number of service users were spoken with and some staff members. Records were viewed and the Manager and service users showed the inspector around the premises. Feedback was received from 15 service users and 6 relatives by comment card. There have been a number of improvements made since the last inspection of the home. What the service does well: What has improved since the last inspection? What they could do better: More staff should be recruited to permanent posts. Whilst there are enough staff on duty many of these are agency staff. Service users would benefit from a consistent staff team. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 6 Service users in the bakery would benefit from a refurbishment of the kitchen. It is very worn and not safe for them to access. It would benefit service users to have a fully accessible kitchen where they can develop their skills and be more involved in preparing their own meals. It is recommended that more staff complete their NVQ award and that the Manager complete the NVQ 4 in care. 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. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 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 the following standard(s): 1, 2, 3, 5 Service users have the information they need to make a decision about the home and they have an individual contract with the home. Service users have their needs assessed and know that the home will be able to meet their needs when they move in. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: The Statement of Purpose and Service User Guide have been updated. Both documents are clearly presented and give service users the information they need about the home. Each service user has been issued with a new contract for the care they receive at the home. Service users have their needs fully assessed before they move into the home. The home is able to meet the needs of most of the people living at Berkley house. However, many of the service users have been at the home for a number of years and, for some service users, their needs have changed since their original assessment. For example one service user is now approaching 65 and his needs are changing. Another service user clearly stated that he wished to move on from the home as he did not want to continue to live with the Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 9 same people anymore. The Manager is working with both these people, using Person centred planning to establish their wishes and plan for their futures. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 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 the following standard(s): 6, 7, 8, 9 Service users have an individual plan that meets their needs. They are involved in the running of the home and are supported to make decisions about all aspects of their lives. Service users are supported to take appropriate risks. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: Service users have an individual care plan that identifies their needs and how these needs will be met. The plans have been recently reviewed and the Manager has collated the information into an easy to follow document for staff. The plans are now clearer and cover all service users needs. Out of date information has removed from the care plan to ensure the proper support is given to service users. Person centred planning is being used with service users to help them plan their lives and map their dreams for the future. There were some very positive Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 11 examples of this seen in the granary. Service users are being supported to make decisions about where they would like to live, gaining employment and building relationships. Staff have a good understanding of the principles of person centred planning and were very positive about promoting the rights of the service users. Regular meetings in each home are used to encourage service users to be involved in the running of the home. Service users said that they had been supported to choose the décor of their rooms and were being consulted on new furniture for the communal areas. Examples were seen of how service users are involved in menu planning, cooking and other household chores that are an important part of managing your own home. Risk assessments are in place for activities that service users are involved in. The risks around supporting service users to manage any aggressive behaviours were discussed with the Manager. These are under review in consultation with external professionals. The Manager must ensure that these risk assessments provide staff with clear guidance on how to prevent and manage aggressive incidents. These should be reviewed after any serious incident of aggression. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 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 the following standard(s): 11, 12, 13, 16, 17 Service users have opportunities for meaningful activities, employment and education. Service users rights within the home and the local community are promoted. Service users enjoy a healthy diet with plenty of choice. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: Service users are supported to participate in a range of activities that are appropriate to their needs and wishes. Some people have jobs or attend college to learn new skills. There is provision on site at the resource centre for those who wish to use it. Various courses and skill development sessions are provided here and service users can access this based on an assessment of their need. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 13 A timetable of the planned activities for the month was seen in the main house. Staff said that service users can choose whether to participate or not. Activity record sheets are completed each month to show what each person has participated in and enjoyed. These are passed to the Manager who can review the types and quality of activities offered. Service users can access facilities in the local community independently, if they are able, or with staff support. There is a vehicle available for them to use or public transport. Service users enjoy using the local pubs, restaurants and shops, cinema and bowling alleys. Some service users go horse riding. Service users’ rights within the home are promoted by staff. Service users said that they were involved in making decisions about things that happen in their home. All bedroom doors have locks and service users can have a key if they wish to or are able to use one. Staff on duty were interacting with service users in a positive way and involving them in what was going on in the home. Staff were talking with service users and helping them to plan their activities. It was clear that staff were aware of the importance of empowering people. Examples of the menus used for all three parts of the home were seen. These are used as a basic menu and can be changed if service users choose to have something else to eat. Meal times are based around service users activities and their preferences. Service users said they enjoyed the meals and that they liked being involved in choosing and cooking. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 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 the following standard(s): 18, 19, 20 Service users have their personal support and health needs met. They are protected by the homes procedures for storing and administering medication. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: Service users’ personal care needs are identified in their individual plan. Staff have received training in manual handling, communication and sexuality which assists them to provide sensitive personal support to service users. Service users health needs are met through the PCT. Where specialist support is required referrals have been made to external professionals. All health interventions are recorded and reviewed in the keyworkers 6 monthly report. Medication is stored and administered safely. All staff have either attended or are booked to attend training in medication administration. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 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 the following standard(s): 22, 23 Service users are protected from abuse. They know how to make a complaint if they need to and they feel that their concerns will be listened to. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: Service users spoken with knew who to speak to if they had any concerns. The complaints procedure is produced in symbol format and has been provided to each service user. Staff have supported service users to understand the procedure. The Manager was asked to include the requirement that the home respond to all complaints within 28 days in the complaints procedure. There has been 1 complaint made to CSCI about the home since the last inspection. This was about the transport arrangements for a relative. CSCI found that the Regard Partnership had appropriately managed the complaint and the complaint was not upheld. Service users have regular meetings in the home where they can raise any concerns about their support or the way the home is being run. The Manager spends time in each one of the buildings each day to talk to service users and staff. All staff have either completed training in the protection of vulnerable adults or are booked to attend. Staff clearly demonstrated an understanding of their role to protect service users and their rights. Service users financial affairs are protected by the homes policies. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 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 the following standard(s): 24, 26, 27, 28, 30 Service users live in a homely and comfortable environment. They have access to sufficient communal and private space and have access to sufficient bathroom facilities. Service users would benefit from a review of the kitchen in the bakery to promote their independence. The overall outcome in this area is adequate. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: All parts of the home were clean and hygienic. The home consists of 3 buildings that are within the grounds, all accommodated by small groups of service users. Each home generally reflected the needs of the people living there. Service users said that they had been involved in choosing the décor for the home and had been able to bring all their belongings to their rooms. Some service users showed the inspector their bedroom. These were personalised and provided a comfortable private space for service users to enjoy. Each person is offered a key to their bedroom and staff do not enter without their permission. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 17 Service users had access to sufficient communal space. The Manager described plans within the bakery to provide another quiet lounge so that service users can choose where they would like to spend their time. There are plans to replace some of the furniture in the communal areas of the home. There are sufficient bathroom facilities for service users although the Manager said that service users would benefit from one bathroom in the windmill being refurbished to provide better facilities for people with mobility difficulties. The kitchen in the bakery requires refurbishing. It is not designed to allow service users safe access to the kitchen. There is a large industrial oven that would not be easy or safe for service users to use. Some parts of the kitchen were worn and units were damaged. Consideration should be given to promoting service users independence as well as safety of service users when planning to update this kitchen. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Service users are supported by staff that are trained and competent. They would benefit from more staff being recruited to ensure an effective team. Service users are protected by safe recruitment procedures. The overall outcome in this area is adequate. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: Ten staff have completed their NVQ award or are working toward it. The Manager is working to achieve the recommended 50 of staff holding an NVQ. All staff undertake a full induction. The training matrix shows that staff have completed a range of training courses including health and safety, 1st aid and Manual Handling. Additional training has been undertaken including CPI, Behaviours that challenge, Epilepsy, communication, person centred planning and autism. Where new staff have joined the home the Manager was able to evidence that training had been booked. Staff files were sampled and it was clear that safe recruitment procedures are being followed. There are a number of staff vacancies that need to be filled and this has resulted in high use of agency staff. The Manager said that regular agency staff are booked to ensure as much continuity as possible for service users. Agency staff do not work in Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 19 the home until a evidence of their suitability to work has been obtained from the agency. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 Service users benefit from a well run home and clear leadership of the staff. They are consulted on their views of the home and their health and welfare are, on the whole, well protected. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: The new Manager has been successfully registered with CSCI. It was evident throughout the inspection that a number of improvements had been made in the home and that the Manager was focussed on a clear action plan to raise the standards of care. Both staff and service users were comfortable with the Manager and staff said they felt very supported. Both staff and service users said the Manager is approachable. It was noted that the Manager has spent time getting to know the service users well and assessing their needs. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 21 The Manager holds a Diploma in Management Studies and the need to pursue a recognised care qualification to support this was discussed. The Manager has used a range of methods for gathering the views of the service users in the home. Regular meetings, Person centred planning and review meetings are all opportunities for service users to share their views. The Manager monitors the quality of the service through daily and monthly auditing of records. A monthly regulation 26 visit is carried out and a recent quality audit of the home has been completed. Risks to service users safety and welfare have been assessed and minimised. As reported under standard 9 the risk assessments for service users to manage any aggressive behaviours must be kept under review and must protect staff as well as service users. Generally the environment provides a safe home for service users, with the exception of the kitchen in the bakery that is not suitable for them to use at present. Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 22 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 3 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 3 27 2 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 2 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 x 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 3 3 x x 3 x Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 23 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 YA24 Regulation 16(2h) Requirement The registered person shall, having regard to the size of the care home and the number and needs of service user, provide adequate facilities for service users to prepare their own food and ensure that such facilities are safe for use by service users; In that, the kitchen in the bakery requires some refurbishment to ensure it is hygienic and safe. When planning this consideration should be given to making it safe and accessible for service users to use. An action plan should be received outlining the proposed timescale for this work. The action plan should be received by the set timescale date (28/07/06) 2 YA22 22(4) The registered person shall, within 28 days after the date on which the complaint is made, or such shorter period as may be reasonable in the circumstances, inform the person who made the DS0000023892.V294654.R01.S.doc Timescale for action 28/07/06 30/06/06 Berkeley House Version 5.1 Page 24 complaint of the action (if any) that is to be taken. In that, the complaints procedure must include the timescales for responding to the complainant. 3 YA33 18(1a) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users; In that, sufficient permanent staff must be recruited to provide a consistent service to service users. 31/07/06 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 YA9 Good Practice Recommendations It is recommended that risk assessments for aggressive behaviour are reviewed after all incidents and that they provide clear direction for staff to manage aggressive incidents. It is recommended that at least 50 of the staff are qualified to NVQ level 2 or above. It is recommended that the Manager complete the NVQ level 4 care award. 2 3 YA32 YA37 Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI Berkeley House DS0000023892.V294654.R01.S.doc Version 5.1 Page 26 - 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. 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