Inspection on 20/04/05 for Betsham Road (84)

This inspection was carried out on 20th April 2005.

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

Betsham Road (84) 13/09/07

Betsham Road (84) 18/05/06

Betsham Road (84) 29/09/05

Betsham Road (84) 28/10/04

Betsham Road (84) 22/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 BETSHAM ROAD 84 BETSHAM ROAD ERITH KENT DA8 2BG Lead Inspector PETER DANIEL UNANNOUNCED 20 APRIL 2005 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. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service BETSHAM ROAD Address 84 BETSHAM ROAD, ERITH, KENT DA8 2BG 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) 01622-769100 MCCH SOCIETY LIMITED MRS CHRISTINA LESLEY HARRIS CRH- CARE HOME 9 Category(ies) of LD- LEARNING DISABILITY BOTH GENDERS - 9, registration, with number LD- LEARNING DISABILITY BOTH GENDERS - 2, of places OVER 65 YEARS. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 28/10/04 Brief Description of the Service: Betsham Road is a Care Home managed by Maidstone Community Care Housing. The service provides 4 self-contained flats for adults of both genders, aged 18 to 65 years with moderate/severe learning difficulties. The flats are joined at a central point and are staffed at all times. The home accommodates 9 service users in total. Betsham Road is situated in a small cul-de-sac in a residential area close to Erith Town Centre. There are bus routes and local shops near by. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? What they could do better: These are set out within the requirements as follows:- the need for more frequent consultation with service users by means of flat meetings; the need to offer supervision to staff at least six times a year; the requirement for staff to undertake training in adult protection; better monitoring of the home through registered provider visits; the refurbishment of parts of the building as specified in the report. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 6 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. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 4, 5 Staff have learnt strategies for communicating with residents and ascertaining their wishes and feelings. Prospective users have the opportunity to visit the home and stay over before making a decision about their long-term stay. Service users still do not have written contracts despite a previous requirement. EVIDENCE: 1. Since the last inspection, the Statement of Purpose has been amended and now includes the information as specified in Schedule1. This was seen as evidence and provides service users and relatives with appropriate information for them to make an informed choice about where they want to live. Prospective users are given a Service User Guide. 2. Evidence was seen on service user files that regular assessment of service user needs is being done through individual planning meetings, risk assessments, personal health profiles and professional meetings 4. Service Users are invited to visit the home before being offered an overnight stay. During the previous inspection, the inspector witnessed a family making an introductory visit. The prospective service user has now moved into the home. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 9 5. At the last inspection, it was noted that a written contract with the service user had still not been made available or placed on the service user’s file. This had also been set as a requirement at the previous inspection. Service users still do not have written contracts. The original contracts are still being held at head office but a copy needs to be held locally. This has been set as a requirement. See requirement 1 BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 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) 6,7,8, 9,10 Service users needs are being fully met and they are subject to regular reviews. The Service user’s and their relatives are involved in decisions that concern their individual development and in the running of the home. EVIDENCE: 6. Service user’s needs are being assessed. The inspector perused service user files and saw evidence that reviews of the service user’s individual plan are held six monthly. The Individual Plan included a strengths and needs list, a risk assessment, a health profile and mental health assessment, an assessment of eating and drinking habits, an assessment of communication skills, leisure interests, occupation skills and self image. 7.8, 9, 10. Evidence was shown on service user’s files that service users are helped to make decisions about their lives and are supported by a key worker and /or relative. Different communication techniques are used to help elicit service user’s views. Service users are consulted on and participate in all aspects of life in the home. A risk assessment is undertaken although no service user is ever left unsupervised because of the nature of their learning difficulties. Each flat holds meetings where service users can make their views BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 11 known. These meetings need to be held on a more regular basis i.e. monthly and this has been set as a requirement. See requirement 2. Information held on service users is kept securely in each flat. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 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) 12,13, 15, 16, 17 Service users are encouraged to have opportunities towards self-development, as appropriate. They are supported and helped to retain links with family and friends and participate in activities and the local community. Service users are offered a healthy diet. EVIDENCE: 12. From reading files and talking to service users there was evidence that service users take part in activities and are also involved in the community. Two service users go to church regularly. Another attends a Resource Centre. One resident attends a college course in cookery and another is learning about communication. Some residents attend a ‘pop in’ parlour once a week. 13. From discussions with the manager and talking to staff, there was evidence that the home organises trips to local shops, the park, local pubs, the cinema and theatre. The inspector perused a service user’s file and saw evidence that during the same week the resident had been shopping, visited a local disco, attended church and went for hydrotherapy 15. Service users are encouraged to retain close links with their family and friends. One service user informed me that his sister visits frequently and this BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 13 was confirmed on file. He also said he has contact with people from the church. Individual planning notes on service user’s files and key worker notes showed that the home supports its residents in having contact with their families. 16. A number of the residents have severe learning difficulties. The client group is highly dependent. Service users do not go out unsupervised. However, the inspector observed staff promoting individual choice and freedom of movement as appropriate. Each flat is self contained and service users have freedom indoors to move around as they wish. and there is a high level of supervision within the home. 17. The inspector observed food menus and observed inside of the fridge and cupboards. A balanced diet is available to service users. There was also evidence of fresh food and vegetables. A service user spoke positively to the inspector about the food provided at the home. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 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) 18, 19, 20 Service users receive good quality health care and receive sensitive and flexible personal support. EVIDENCE: 18. The home operates a key worker system and staff were observed providing sensitive and flexible personal support to maximise the service user’s privacy, dignity and independence and control over their lives. One service user had reached a crisis point and had lost mobility. The staff were observed to be very caring about his needs. Another service user told me that he ‘liked living at the home’. 19. All service users have a personal health profile which cover’s their health needs. There was evidence in the personal health profile that service user’s physical and emotional health needs are being met. The home plans to introduce a health action plan and establish the role of health facilitator ( this is likely to be part of the key worker’s role). The health action plan will help coordinate all health information. 20. The MARS sheet folder was seen and MARS sheets had been signed and dated accordingly. The home uses the monitored dosage system. The shift coordinator has a duty to ensure that medication has been administered. None of BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 15 the service users are permitted to self medicate and all medication is administered. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 16 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 Service users views are listened to and acted upon. Service users are protected from abuse but some staff are still to undergo training in adult protection EVIDENCE: 22. There have been no complaints regarding service users since the last users. The log does include an informal complaint concerning two members of staff. 23. The home has an adult protection policy that was seen as evidence. Some staff have received adult protection training. Five staff still need to undergo this training and this has been set as a requirement. See requirement 2 BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 17 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, 30 Service users live in a comfortable, safe and clean environment. Some refurbishments are needed as defined under requirements 4 and 5. EVIDENCE: 24. The home has two ground floor and two first floor flats that are self contained. The flats are spacious and homely. The inspector saw evidence of this when he visited one of the flats and a service user’s bedroom The last inspection set a requirement to re-site the cooker in Flat C from its hazardous position near the kitchen door. This has still not been done although there have been two site meetings. No firm decision has been made. A further requirement has been set. See requirement 4. This is now urgent. There are other outstanding refurbishments from the last inspection as follows:- the ceiling in flat D and GDs bedroom need artexing; the carpet on the stairs to flats C and D need to be replaced. It is understood that quotes will soon be done. See requirement 5 Another requirement was to carry out remedial work regarding electrical wiring and this was completed on the 14th April 2004 BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 18 30. The home was observed to be clean and hygienic. The issue of dealing with soiled laundry was discussed since it impacts on hygiene and infection control. The home does not have a suitable washing machine to deal with soiled clothing/ bedding. It was agreed in the short term that all soiled laundry will be laundered off site and safely stored. Should the home decide to accommodate more elderly/ incontinent service user’s in the future, it will need to make a decision about locating a laundry facility in a separate area to the house e.g. a separate building in the garden area or continue to deal with soiled laundry off site. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 19 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, 35, 36 The home has a well trained workforce. A requirement has been set to increase the frequency of supervision to staff and also to clarify the manager’s role. EVIDENCE: 31. The manager has a dual role as manager and carer. This does not always rest easily and places the manager under additional pressure. It is recommended that there is a review of the manager’s responsibilities and duties. It is suggested that the manager should attend exclusively to her management responsibilities. See recommendation 1. 35. There have been no staff changes since the last inspection. The home has a well-trained workforce. The manager has an NVQ level 4 qualification, a registered Manager’s Award and a Certificate in Management. One of the Senior Support Workers has an NVQ level 2 qualification and the other a Certificate in Health and Social Care equivalent to an NVQ level 3-4. The majority of staff have an NVQ 2 or 3 award. Two are currently completing NVQ training. That leaves two staff who still have to start the training – it is anticipated that they will start the training in September. The requirement that 50 of care staff need to have an NVQ level 2 in Social Care Training by 2005 has been achieved. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 20 Staff have attended other training including HIV training, medication, adult protection and first aid. One urgent requirement has been for staff to do movement and handling training. The home has given this aspect of training a priority and the majority of staff were undertaking the training, the day following the inspection. 36. Staff receive supervision, although the manager acknowledges that it has not always been possible to offer it on a regular basis i.e. at least six times a year. Senior staff are now helping with supervision. Bank staff are now being supervised. A requirement has been set for staff to have regular supervision meetings at least six times a year with their line manager. See requirement 6 BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 21 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) 39, 42 Service users benefit from a well run home. The health and safety of users is promoted. Quality assurance, in the form of regulation 26 inspections, need to be carried out on a more regular basis. EVIDENCE: 37. The home is well run. The manager is qualified, competent and experienced to run the home. The home is meeting its stated purpose, aims and objectives. The home has appropriate policies and procedures in place and the budget is properly managed. Staff meetings are held once a month and the manager is able to communicate a sense of direction at these meetings. Evidence was seen of staff meeting minutes. There was also evidence of good record keeping and files are kept in a secure cabinet. 39. Service users are consulted about their views concerning the running of the home. They also talk to their key worker on a regular basis. The inspector examined two files and saw evidence of service user’s individual plans that BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 22 included a record of agreed action and evidence that the service user had been consulted. The inspector noted that regulation 26 reports are not being completed on a regular basis. None had been done between June 2004 and April 2005. A new person has been identified to carry out the regulation 26 inspections. A requirement has been set for the regular completion of Regulation 26 reports. See requirement 7. 42. The home promotes the health and safety of service users. There is a procedure to carry out a health and safety ‘walk-around’ on a regular basis and monitoring logs were seen as evidence. All new staff have done Adult Protection training as part of their induction. In terms of safety, the following tests/ inspections were seen to have been carried out:Electrical wiring inspection on the 14/4/04; portable appliance equipment test and certificate 9/7/04; gas safety checks including boiler check October 2004. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 23 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 3 x 3 1 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 2 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score 2 3 x 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 BETSHAM ROAD Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 1 x x 3 x G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 24 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 5 Regulation 5(3) Requirement The registered person must ensure that a copy of the contract is held on all service users files The registered manager must consult service users on a more regular basis and flat meetings should be held on a monthly basis. The registered manager must ensure that all staff receive training in adult protection The registered manager must ensure that the cooker in the kitchen is re-sited in a safe place. This is now urgent. The registered manager must ensure refurbishment of the following:- the ceiling in flat D and GDs bedroom need artexing; the carpet on the stairs to flats C and D need to be replaced. The registered manager must ensure that staff have regular one to one supervision with their line manager. at least six times a year The registered manager must ensure the regular completion of regulation 26 reports Timescale for action 30.6.05 2. 7 16 (2) 30.6.05 3. 4. 23 24 19 (5)(b) 23 31.7.05 31.7.05 5. 24 23 30.9.05 6. 36 18 31.7.05 7. 39 26 31.7.05 BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 25 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 31 Good Practice Recommendations The provider should review the managers role whereby she is expected to carry out the dual role of manager and carer. BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection SIDCUP AREA OFFICE, RIVER HOUSE, 1 MAIDSTONE ROAD, SIDCUP KENT DA14 5RH 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 BETSHAM ROAD G51S37836Betsham Rd V221562 20-04-05 Stage 4.doc Version 1.30 Page 27 - 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. 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