Inspection on 03/03/06 for Canary House

This inspection was carried out on 3rd March 2006.

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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Canary House 20/11/06

Canary House 14/07/05

Canary House 14/12/04

Canary House 14/07/04

Canary House 18/02/04

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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 Canary House 41/43 Kingswood Road Gillingham Kent ME7 1DZ Lead Inspector Sue McGrath Announced Inspection 3rd March 2006 10:00 Canary House DS0000029051.V278130.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 Canary House DS0000029051.V278130.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. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Canary House Address 41/43 Kingswood Road Gillingham Kent ME7 1DZ 01634 319398 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) Mrs Congetta Mantegna Mr Fabio Mantegna Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care is restricted to three people with learning disabilities between the ages of 30 to 65 years of age, with the exception of one service user whose date of birth is 22 May 1925. 14th July 2005 Date of last inspection Brief Description of the Service: Canary House caters for three service users with learning disabilities, who live as part of an extended family. It is in a residential area of Gillingham and is two houses made into one. Close to the main line station and bus services the Home can be easily reached by public transport. The town centre is within walking distance, and has a good selection of stores. The area also has a number of amenities such as a local leisure centre and the historic dockyard at Chatham. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection under the terms of the Care Standards Act 2000 and was carried out by one inspector who was in the home from 10.00 to 13.30 on the 3rd March 2006. The Inspector agreed and explained the inspection process with the Registered Provider. All of the service users were out on the day of inspection, so it was not possible to include their views in this report. Documentation and records were read, including care plans. Time was spent reviewing a sample of written policies and procedures, looking at care plans and records kept within the home. A tour of premises was undertaken. The overall outcome was that the residents enjoyed a good standard of care and were encouraged to maintain their independence. They enjoyed living as part of an extended family. What the service does well: What has improved since the last inspection? There were no new improvements to document during this latest inspection; it appeared the home continues to provide a high standard of care to its service users. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 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. Canary House DS0000029051.V278130.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 Canary House DS0000029051.V278130.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): 2, 3, and 4 The home’s Statement of Purpose and Service User Guide are comprehensive and provide prospective residents with the information they need to make an informed choice about moving into the home. Prospective Residents can be confident the home will meet their needs and aspirations. EVIDENCE: Evidence taken from the last inspection. No changes had occurred. To assess the assessment process for a home that has three long-term residents who are unlikely to change in the near future is difficult, as the pre assessments were done years ago. The owner has however produced a format for use should the need arise future, and when complete would cover the required information on which to base suitability for the home. Visits to the home prior to any admission would be part of the admission process if ever used. The resident’s care plans and daily logs, indicated that the residents’ needs were being met. A person qualified to do so is doing the assessments. The residents do have input into the plans, ensuring they receive the care they choose. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 9 Residents have been issued with their own copy of the terms and conditions of their stay in the Home. The local authority is responsible for the placement of the service users and the Home has a contract with the local authority for each individual service user. The terms and condition covered the required information. Canary House DS0000029051.V278130.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): Residents are included in the care planning process and know their care needs and personal goals are reflected in the plan. Residents are supported to make decisions about their lives. Residents are consulted and encouraged to participate in all aspects of life in the home. EVIDENCE: Evidence taken from the last inspection. No changes had occurred. The residents’ files each contained an individual care plan that had been developed with the resident. The owner and the residents review the plans monthly and evidence was seen of this since the residents sign at each review. The residents are encouraged to set new goals in their personal development. The daily log reflects the plans of care and records the monthly reviews and comments made by the residents. The daily log is now completed daily on the computer. When the page is full it is printed off signed and added to the residents file. The computer is password protected. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 11 The documentation in the Daily Log showed where support is being given to residents and also indicated where residents are being encouraged to make choices. Any limitations have been addressed through the risk assessment process, which is also discussed with the residents. Residents are offered opportunities to participate in the day-to-day running of the home. This was evidenced in minutes of the meetings they hold within the Home. Evidence of the various jobs that residents have been made responsible for during the coming week were listed on the notice board. Residents were aware of what their responsibilities are and in past inspections have said they enjoy taking part and helping within the home. Each week the 7 household members who include the family choose a main meal, one for each night of the week. Written risk assessments were available for each resident. Each risk assessment highlighted any risk to the resident and how this risk could be minimised. Some element of risk remained but this was managed. These risk assessments were found to be current and evidence was also seen that these have been reviewed regularly. As some of these assessments are unlikely to change they are reviewed less often, although the residents are still reminded regularly about the risks. The Home has a comprehensive policy on confidentiality and the owner showed a good understanding of the Home responsibility towards this. All documentation regarding the residents is kept in a locked filing cabinet and information on the computer is password coded. Canary House DS0000029051.V278130.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): The home ensures residents have the opportunity for personal development. The home is conscious of the different ages of service users in the home and activity and outings are arranged accordingly. Residents are part of the local community and are aware of forthcoming events in the town and locality. Family involvement is encouraged and facilitated by the home for the benefit of the residents. The residents can be confident that their rights are respected and clear responsibilities are agreed with them. The residents enjoy the benefit of balanced meals taken in congenial surroundings in a family atmosphere. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 13 EVIDENCE: Evidence taken from the last inspection. No changes had occurred. Residents are encouraged to do what they can for themselves; they are also encouraged to learn new skills. In the residents care plans new tasks are identified and a time scale agreed. Arrangements are made for residents to go to clubs and a day centre a three times a week. The owner said that they always have time to talk to residents individually during the day and some outings such as football are arranged on an individual basis. One resident is very independent and a risk assessment is in place as he goes out alone most days. Other residents need a little more supervision, but the owners said they keep this to minimum to encourage independence. It was obvious that the residents have a lot of opportunities to go out and about. They go out for meals, they go shopping, and one resident is a regular visitor to the library. One resident is able to attend training courses and enrols in classes e.g. Art for Life and ‘ Historically Speaking’. Employment is not a possibility for the residents at this home but is kept under review. Due to the different ages each residents goes to different day centres and /or educational courses. The owners explained that when there are events happening locally then they often go together like a family. Occasionally one may not want to go and no pressure is made since it is their choice. The service users are encouraged to use the local amenities, such as the social club, and this was seen documented in the service users daily log The resident’s family are encouraged to visit and stay in touch with the residents. The home has a phone that the residents are able to use at any time. The resident’s next of kin is kept informed of all health matters etc. The Residents went to Italy for six weeks on holiday last year. Each year a holiday is arranged. The owners complete a risk assessment for the trip and ensure they have the relevant insurance. The residents’ records are kept up to date on holiday and the residents care managers had been informed. The Home has got a games room where they can play darts and pool. The residents have their daily routines but they are flexible depending on what they choose to do and what is happening on any one day. This was evident from the daily log and the resident’s care plan. Residents are encouraged to make choices and this was also evident in the minutes of the meetings. Residents are encouraged to help around the home and to keep their own bedroom both clean and tidy. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 14 The residents and the family at the Home each choose one main meal each day of the week. The choices are recorded on a display board. The residents enjoy choosing each week because they can have their favourite. The menu seen was varied and the owners confirmed that most of the meals are home cooked from fresh ingredients. Meal times are flexible and fit around what residents are doing. Snacks are available during the day and service users can help themselves to drinks whenever they want. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18-21 Residents receive personal support in a way they prefer and their independence is encouraged. Health needs are met and residents benefit from having full access to all professional health care services as required. Some areas of the administration of medication could be improved. Residents are treated with respect and can be assured the home will handle the issue of illness and ageing sensitively. EVIDENCE: Little personal care is required since it is only necessary to prompt service users to attend to their personal hygiene needs. Some help is required with bathing but this is mainly with help in and out of the bath. Residents are encouraged to put their dirty clothes ready for the wash etc. this is documented in the service user plans and daily log. The owner said that the residents all being men often spoke to her husband about sensitive issues. All residents have their own GP. The owner monitors their health care needs closely and appointments are made at the doctors when needed. The owners Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 16 do go with the resident and are on hand if the resident wants them to go in with them. Any health problems are recorded in the daily log. Other appointments with other health professionals such as optician, chiropodist are made as required. Visits are detailed in the day log and the care manager informed if appropriate. The home’s administration of medication was assessed and some areas of concern were noted. One of the main issues was that the person administering the medication was not signing at the time of administration. The proprietor said that often signing was left for several days before the relevant spaces on the time sheet was signed. The MAR sheets must be signed at the time of administration. The home was also advised to obtain a copy of the guidelines issued by the Royal Pharmaceutical Society of Great Britain for future reference and guidance. It was also advised that the proprietor should complete accredited training in the safe administration of medication and advice was left about relevant courses. One of the residents self-administered their own medication and the proprietor was advised to complete a risk assessment to ensure this practise was safe. Discussion took place around ageing, illness and death of a resident. The proprietor was advised to write a policy and involve the residents and their families where possible to ensure that final wishes were recorded and when needed, acted upon. The proprietor stated that it was expected residents would be able to receive treatment and care in their own rooms, if that was their wish, unless there was a medical reason for an alternative setting. This issue is relevant because of the age of some of the residents. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home has robust complaints and adult protection policies and procedures in place for the protection of the service users. EVIDENCE: The inspector saw the complaints procedure of which each service user has a copy. The procedure contains timescales by which any complaint would be dealt with. The Home has had no complaints since the last inspection. The home has a copy of the new local authorities protocol for notifying any suspected abuse as well as their own which is being reviewed to ensure it reflects the local authority protocol. There are no staff employed at the home but a policy is in place in case this changes. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 18 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): 24-30 Residents benefit from living in a clean, safe, well-maintained environment and have safe access to comfortable indoor and outdoor communal areas. EVIDENCE: The home was situated close to local amenities and the local high street with a range of shops and a library. A main line train station was only minutes away. The premises were accessible to all residents and they had access to a pleasant garden to the rear of the building. The living areas were very comfortable and homely. The furniture and fittings were of a good quality and were domestic in nature. The dining area was well decorated and very clean. The lounge was spacious and well maintained with a television and a computer. The residents also had use of a games room in the basement with facilities for snooker, darts, an exercise machine and a television. There were two bathrooms; the upstairs bathroom held a shower and a toilet. All were well maintained and clean. As the residents were not at home their rooms were not fully inspected but it was noted that all were well maintained. It was evident that the rooms met the needs of the residents in the home. All of the bedrooms were single rooms. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 19 All of the residents were fully ambulant, so no specialist equipment to aid mobility was required. The home generally was clean and hygienic throughout and systems were seen to be in place to control the spread of infection. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 20 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): EVIDENCE: The home does not employ any staff so these standards were not inspected. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 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 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): The residents benefit from living in a home where the manager is competent, enthusiastic and very experienced with the care of people with a learning disability and has a clear vision for the home. Residents could be at risk due to a lack of current mandatory training. EVIDENCE: Mrs Mantegna has achieved her NVQ level 4 Registered Mangers Award; she also ensures that she continues to do courses to keep her certificates in date. Owing to the moving and handling course being cancelled several times she is not current. The owners have a very open approach with their Residents who enjoy a very family orientated type of care and are encouraged to maintain their independence. The home does not cuurently have any effective quality assurance and quality monitoring system in place and discussion took place about the best way to Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 22 ensure this standard is fully met. It was advised that the home had an annual development plan, based on a systemantic cycle of planning, action and review that reflects the aims and outcomes for residents. It was suggested that feedback should be sought from residents, their represenatives and any other interested parties such as Care Managers, G.P’s Distriact Nursed,if used and other healtcare professionals. The results of the reisdent surveys need to be published and made available to residents, their representatives and other interested parties including the Commission. The required policies and procedures were in place and these need to be dated, monitored, reviewed and amended as required on a yearly basis. All of the records seen were secure, up to dater and well maintained. Basic Food Hygiene certificates were seen to be out of date and need to be retaken. Moving and handling training is also out of date. The proprietors were also advised that at least one of them should complete a full first aid course (First Aid at Work –4 Days). The water temperature were not controlled by individual thermostatic mixer valves but the proprietor stated that the boiler was regularly tested and that the family used the same hot water and no problems had been highlighted. It was advised that water temperatures should be recorded monthly to ensure they could evidence safe temperatures. Fire drills were regularly undertaken and evidence was seen that these were regularly discussed at residents meetings. It was also advised that the Health and Safety Statement be signed by the registered provider. Appropriate insurance cover was seen to be in place. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 2 3 3 1 3 3 2 X Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 24 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 YA42 Regulation 13(4)(5) Requirement The registered person ensures so far as is reasonably practicable the health, safety and welfare of service users and staff in that accredited Moving and Handling training is undertaken. Action plan required. The registered person ensures so far as is reasonably practicable the health, safety and welfare of service users and staff in that accredited Basic Food Hygiene training is undertaken. Action plan required. The registered person ensures so far as is reasonably practicable the health, safety and welfare of service users and staff in that accredited First Aid training is undertaken. Action plan required. The registered person ensures so far as is reasonably practicable the health, safety and welfare of service users and staff in that accredited Administration of medication training is undertaken. DS0000029051.V278130.R01.S.doc Timescale for action 14/04/06 2 YA42 16 (2)(g)(j) 14/04/06 3 YA42 13(4)(c) 14/04/06 4 YA20 18(1)(c) 14/04/06 Canary House Version 5.1 Page 25 Action plan required. 5 YA39 24(1)(a)(b) The registered person shall (2)(3) ensure that an effective quality assurance and quality monitoring systems, based on seeking the views of service users, are in place to measure success in achieving the aims, objectives and statement of purpose of the home. Action plan required. 14/04/06 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. 2. 3 4 Refer to Standard YA20 YA42 YA21 YA40 Good Practice Recommendations It is recommended that a copy of the guidelines from the Royal Pharmaceutical Society of Great Britain be obtained. It is recommended that water temperatures are regularly recorded. It is recommended that the home has a written policy on the ageing, illness and death of residents. it is recommended that all policies are dated, monitored , reviewed and amended regularly. Canary House DS0000029051.V278130.R01.S.doc Version 5.1 Page 26 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. 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