Inspection on 03/11/05 for Canterbury Adult Support Unit

This inspection was carried out on 3rd November 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 no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Canterbury Adult Support Unit 16/05/07

Canterbury Adult Support Unit 17/07/06

Canterbury Adult Support Unit 05/07/05

Canterbury Adult Support Unit 15/03/05

Canterbury Adult Support Unit 08/04/04

Similar services:

Southfields

Thorndene

Insight - Eastchurch

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 Canterbury Adult Support Unit 88 Whitstable Road Canterbury Kent CT2 8ED Lead Inspector Clair Brown Announced Inspection 3-4 November 2005 10:20 Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 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 Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 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. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Canterbury Adult Support Unit Address 88 Whitstable Road Canterbury Kent CT2 8ED 01622 671411 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) tim.birchley@kent.gov.uk Kent County Council Mr Tim Birchley Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th July 2005 Brief Description of the Service: The home is a three-story, semi detached property. It is currently owned and operated by Kent County Council as part of the “Canterbury Adult Support Service”. The home is registered to provide short-term respite care for up to eight persons at a time, aged from 18 years to 64 years, who have a learning disability. However the home has reduced its shared bedrooms and is now only able to accommodate five service users. There is a ground floor bedroom with en-suite WC and walk in shower. There are some adaptations but the premises are not currently judged accessible for individuals with mobility impairment. The home also provides a day care service. The home is located about 1.5 miles from Canterbury City Centre and is on a direct bus route to the seaside towns of Herne Bay, Whitstable in one direction and with Canterbury itself in the other. There are several parking bays on a vacant site to the side of the home and some sections of Whitstable Road. There is a small back garden and patio area which service users are free to use. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s announced inspection. The inspection was conducted by one inspector and the duration of the inspection was 8 hours over two days. The Home representative was the registered manager. Additional time was spent in planning the inspection and report writing. All of the service users were out and involved in daytime activities away from the home but day centre service user who also stay at the home for respite care where available to talk with. Time was spent speaking with the registered manager and staff of the home. A full tour of the premises was conducted, documents, medication and records were examined and service users files were case tracked. Three service users and three relative completed inspection comment cards. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to be developed to clearly identify all of the service users needs and to provide staff with instructions on how to provide the care to meets their needs. The design of the care plan should be appropriate to the abilities of the service users to enable them to be involved in the planning of their care. The care plans should include a nutritional assessment especially for those with special dietary needs. For service users who self medicate especially when outside of the home need to be assessed to ensure they are able to manage their medicine safely. Broken and worn out furniture needs replacing and some carpets are in need of renewal. The procedures for handling soiled laundry needs to be amended to comply with current practices. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 6 The internal process for quality monitoring needs to be expanded and the report developed to include an action plan. 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. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 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 Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 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): 2,3,4,5 Prospective service users are fully assessed, with plenty of opportunity to visit prior to admission for respite. No changes have been made to the service users contract. EVIDENCE: Many of the service users stay at the home several times a year as the home provides respite care. Prospective service users are referred by care management who provide a assessment. Visits to the home are then organized, gradually increasing the duration of the visit. During these visits the home assessment is completed and the registered manager also uses this time to determine if the service user is suitable and their needs can be met. This process also gradually introduces the prospective service users to those currently using the facilities. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 9 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): 6,7,8,9,10 The care planning system is inadequate and does not provide staff with the information they need to satisfactorily meet service users needs. EVIDENCE: The care plan consists of summary page of needs page, with often one word used to describe the service users needs. There are no clear instructions for staff on how to meet these needs. The registered manager has requested a computer system to enable the home to produce a pictorial form of care plan but to date this has not been provided. The files do contain some risk assessments and copies of care managers reviews. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 10 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): 11,12,13,14,15,16 Service users are supported to participate in activities both within the home and in the local community. EVIDENCE: As the home only provides respite care standards 11& 12 are not applicable. The service users enjoy a variety of activities including attending the local day centre, trips into the town (Canterbury), bowling, to the pub and enjoy cooking. This was confirmed when the inspector spoke with service users. They also expressed how much they like their stays at the home. They are supported by kind and friendly staff to participate in their chosen activities and follow their daily routines. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 11 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): 18,19,20,21 Service users are treated with respect and their personal dignity is maintained when personal supported is given. Medication procedures and practices are good, although the procedure for supporting service users who self-medicate does not ensure their safety and welfare. EVIDENCE: Service users spoken with during the inspection expressed how kind and caring the staff are. Observations made of interaction between care staff and service users was relaxed and comfortable, service users were free to express themselves and had a good rapport with those working at the home. As the home only provides respite care standards 21 is not applicable. Service users who self-medicate are not assessed by the home, as able to do this safely. Medicines are also being issued to service users to self medicate when attending day centre. Overall the medication practices by care staff within the home were good, with accurate records being kept. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 12 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): 23 Service users and relatives opinions are listened to and taken seriously. Procedures are implemented to protect service users from abuse. EVIDENCE: The three relative comment cards completed said they know who to talk to if they have any concerns and are aware of the complaints procedure. One added an additional comment to say how “approachable the staff are”. The Home has the Multi-disciplinary team adult protection procedure and added to this “No More Abuse” by Voice UK, which is pictorial. The Home actually has a number of policies and procedures regarding adult protection, which together give staff guidance on appropriate action if concerns are raised. Staff were able to demonstrate a good understanding of these procedures when spoken to. Service users were also very confident about being able to speak out about their concerns and who they would talk to. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 13 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): 24,25,26,27,28,28,30 The Home provides suitable accommodation for the service users. Management of the maintenance of the building is inadequate. Infection control procedures do not prevent the possible spread of infections in the laundry. The home was clean. EVIDENCE: The Home is a large semi-detached house with accommodation provided over three floors with mezzanine levels. The Home has sufficient communal space to meet the needs of the Home and the service users. There are a selection of communal rooms which are utilized according to individual preferences. Although some maintenance work has been carried out there have been delays with some work. The Home is pleasantly decorated but some areas are tired and worn out. The hall carpet is old and stained and although cleaned daily there is no improvement in it’s appearance. The dining table and chairs have been repaired several times and staff raised concerns regarding the safety of the furniture. The registered manager stated these have been included in his budget request but does not know if it will be approved. At the time of the inspection care staff sluice by hand soiled linen, this is an unsafe practice. Access to the laundry area is via the kitchen. There is no procedure in place for the safe transportation of soiled linen to the laundry. The home was clean and the domestic staff work hard to maintain a good standard of hygiene. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 14 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): 32,33,35, During the week sufficient care staff are provided but insufficient care staff are provided at the weekend. Staff have not completed the mandatory training courses and the NVQ training. EVIDENCE: On weekdays many of the service users attend clubs and colleges and therefore there are sufficient numbers of care staff to meet service users needs. Both staff and service users said that activities at the weekend can be restricted due to only two carers being on duty. The training matrix showed that although staff are attending training course, the mandatory subjects are not being covered. Only 4 of the carers have completed the NVQ in care course. Although staff have applied for course, places have not been given. The registered provider, the local authority, runs the course. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 15 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): 37,38,39,40,41 The home is well managed with policies and procedures used to support practice. The quality assurance systems are incomplete and are not in an appropriate format. EVIDENCE: Both staff and service users spoke highly of the registered manager. The overall management and ethos of the home is reflected in the content and relaxed atmosphere service users experience whilst there for respite care. The last quality assurance programme was conducted a year a go and no plans have been made for this years. The report from last years findings did not include any form of action plan after the information had been collated. The registered manager stated they are experiencing problems with producing questionnaires in appropriate formats for the service users. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 16 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 3 3 3 2 Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 2 2 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 2 3 3 2 LIFESTYLES Standard No Score 11 N/A 12 N/A 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 2 2 X 2 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Canterbury Adult Support Unit Score 3 3 2 N/A Standard No 37 38 39 40 41 42 43 Score 3 3 2 2 2 X X DS0000037735.V256409.R01.S.doc Version 5.0 Page 17 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 YA6 Regulation 12,13,15 Requirement Care plans must clearly identify all aspects of an individual service users needs and clearly provide staff with instructions on how to meet those needs. Timescale for action 31/01/06 2 YA6 3 YA17 4 YA20 5 YA24 Service users care plans must be produced in an appropriate format to ensure their understanding and agreement of the content. 14,17 Nutritional assessments must schedule 3 be conducted and reviewed regularly, especially for those with special dietary needs. 12Those service users who are 14,16,17,23 self medicating need Sch 3 assessments conducting and regularly reviewing to ensure safe practice. There must be a risk assessment for the process for taking medication to day centre. 16,23 Furniture (dining room) is replaced with suitable good quality furniture. Furniture assessed as broken and unsafe should be replaced promptly. DS0000037735.V256409.R01.S.doc 12,13,15 01/06/06 31/01/06 31/01/06 01/03/06 Canterbury Adult Support Unit Version 5.0 Page 18 6 YA30 7 8 YA32 YA35 9 YA39 The worn carpets in areas of the home (hallway) need replacing. 12,13,16 A procedure must be produced 23 and implemented for the transportation of linen (including soiled linen) to the laundry complying with infection control procedures. The registered manager to confirm if the washing machine is suitable for the use of alginate bags and to implement their use if possible, to notify the CSCI of outcome. The registered provider to produce an action plan regarding the safe accessing of the laundry area, not using the kitchen. This to be submitted to the CSCI. 18 50 of care staff must have the appropriate NVQ level 2 qualification. 12,13,18 All staff must complete mandatory training. Individual staff training programmes must be developed and implemented. 10,12,15 24 To develop the current Quality Assurance Process further to obtain the views of other professional bodies. After collating the information gathered the report produced should include an action plan. A copy of the report and action plan to be sent to the CSCI 31/01/06 01/10/06 01/06/06 01/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000037735.V256409.R01.S.doc Version 5.0 Page 19 Canterbury Adult Support Unit 1 2 Standard YA5 YA5 3 YA22 4 5 6 YA27 YA29 YA42 7 YA23 Required to review the Service User contract to ensure it meets the requirements of the National Minimum Standards and Regulations. The registered manager should ensure that the “Personal Responsibilities Agreement” articulates service users right to complain about the service provided by the home directly to the Commission for Social Care Inspection. The registered manager should ensure that where information is displayed in the home about the complaints process the information includes the timescale in which a response to complaints will be made. The registered manager should ensure that the ground floor ensuite showerroom is fit for use. The registered manager should ensure that the works reccommneded in the report produced in relation to the access audit is carried out in full. The registered manager should ensure that electrical appliances in the home are safety checked in accordance with guidance published by the National Inspection Council for Electrical Installation Contracting. A two signature procedure to be used for the recording of transactions of service users money. Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Kent and Medway Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Canterbury Adult Support Unit DS0000037735.V256409.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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