Inspection on 21/09/07 for Self Unlimited

This inspection was carried out on 21st September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Self Unlimited 03/05/06

Self Unlimited 31/01/05

Similar services:

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 CARE Edenbridge 1 Phillippines Close Off Hever Road Edenbridge Kent TN8 5GN Lead Inspector Eamonn Kelly Key Unannounced Inspection 21st September 2007 11:15 CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 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 CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 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. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service CARE Edenbridge Address 1 Phillippines Close Off Hever Road Edenbridge Kent TN8 5GN 01732 782700 01732 782701 carekent@care-ltd.co.uk www.care-ltd.co.uk CARE (Cottage and Rural Enterprises Ltd) Telephone number Fax number Email address Provider Web address Name of registered company Name of manager Type of registration No. of places registered (if applicable) Samantha Baxter Care Home 34 Category(ies) of Learning disability (34) registration, with number of places CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th November 2006 Brief Description of the Service: The Cottage and Rural Enterprise Ltd website www.care-ltd.co.uk says that CARE is “a registered charity supporting people with learning disabilities throughout their daily lives…(it) provides a range of supported accommodation, training and work opportunities…tailored to individual need”. The administration building for the company’s regional activities is located at Philippines Close. The Oak Tree Bistro (a catering facility open to the public), Acorns (an eco-friendly horticulture centre providing gardening skills training as well as sales of plants, gardening services and handicrafts to the wider community), day service facilities, four residential premises and a further building (currently used as staff accommodation) are on the site. The Acorns Horticulture Training Centre’s eco-design includes 2 wind turbines, ground source heat pump, solar panels, grey-water recycling and exports power to other parts of the service including residential premises. Facilities for residents and day care visitors include workshop rooms for crafts, skills development and computer work for training and leisure. Each of the four residential premises has individual accommodation for residents and communal catering facilities. Residents may also have meals in the centre’s dining room attached to the public bistro that is used by staff, day service visitors and residents from CARE’s other residential homes at Longfield, Sevenoaks and Biggin Hill. Weekly fees are £670 for Houses 2, 3 and 4 and £878 for House 5. The latter is designed around the needs of people who are older or who have complex needs including dementia. Other charges (eg. for hairdressing, private chiropody, holiday costs, entry fees, transport expenses and contributions to staff expenses) are applicable. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 21st September 2007. It consisted of meeting with the owners, residents and members of staff. A visit was made to each of the residential premises and day care facilities; the report contains references predominantly to procedures at Houses 2 and 5. Care practices were observed and discussed with members of staff. A variety of records was seen during the visit principally those that supported the care of residents. Twelve residents (with staff assistance) and five relatives returned completed questionnaires about their views of the service to the commission. The respondents indicated general satisfaction with the service and further comment from them is included below. What the service does well: What has improved since the last inspection? What they could do better: Residents have advised the commission via its survey that staff are often very busy and may not always have the time to listen to them and act on what they say. They also say that at the weekend staff shortages can result in fewer CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 6 choices available to them. Residents also say that sometimes drivers are unavailable for company MPV-type vehicles. Members of staff say that they are more optimistic about the future following changes in senior management. They refer to difficulties caused by high staff turnover and of how staff rotas are often amended at short notice to enable minimal levels of staff to be on duty at each house. They say that relatively poor pay conditions affects staff retention but that they are optimistic that this will be addressed. This reflection might include assessment as to whether residents and support workers would benefit from assistance by domestic workers. Members of staff and residents have not been best served by reluctance of previous managers to take proper action where large supplies of oxygen are stored and procedures may not have been in resident’s longer-term interests. These issues should be included in care plans and acted upon. Residents in House 5 have not been appropriately supported because members of staff are not receiving thorough training in safe movement and handling and they do not have access to the necessary hoists. Members of staff are concerned at some aspects of poor equality and diversity procedures that affect male residents and are keen to have these concerns addressed by the new service manager. All prospective residents (or their main supporter) should receive a copy of a personal contract that includes information about the rights and responsibilities of both parties including what is and is not charged additionally to residents. They should also receive a copy of an up-to-date resident’s guide when assessments are at an early stage. 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. The summary of this inspection report can be made available in other formats on request. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 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 CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5. People who use the service experience adequate quality outcomes. This judgement was made using a range of evidence including a visit to the service. Prospective residents and their supporters receive initial advice and guidance to help them assess the quality, facilities and suitability of the home and associated services on the site. This procedure would be enhanced if new residents and their main supporter received a personal contract that outlined the rights and responsibilities of both parties. EVIDENCE: Prospective residents and their representatives receive assistance and guidance to enable them to decide if the home is able to meet their support needs. This includes receipt of a written guide that contains information about services and facilities. This guide is a little out-of-date. The personal contract is a simple document that does not include full information about the rights and responsibilities of both parties. The position relating to additional charges made to residents is a little vague, for example, resident’s contributions towards holidays, staff costs on outings and travel expenses. Prospective residents and their supporters are helped to make active decisions about the suitability of the project and premises. Sponsoring organisations and CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 9 families are closely involved, a six month settling–in period is considered appropriate and residents are involved in reviews during this time. The information guide says nursing care is not provided. However, in the event of serious/terminal illness residents remain at the home unless a health assessment indicates that their needs can no longer be met. Procedures in the event of emergency admissions are outlined in the guide. Intermediate support (short-term recuperative care) is not provided. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents are helped to make decisions and to express themselves as part of developing their confidence and quality of life. EVIDENCE: Residents are encouraged to make their own decisions and choices. Members of staff understand the importance of doing this. Care plans and associated procedures are person centred and are agreed using a number of forms of communication with residents and observation by staff. These essential life plans (ELP’s), in the examples seen, contain good information about resident’s needs and how these are being met. An additional file for each resident covering their health and access to health services complements these plans. Plans are easy to understand and look at all areas of each resident’s life. Members of staff have skills and ability to support and encourage residents to be involved in the ongoing development of their plan. They use a variety of CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 11 ways to help individuals make a worthwhile contribution and to receive the support they need. Essential life plans are seen as working documents reviewed regularly and updated as necessary. They are kept up to date and focus on how residents develop their skills, have their changing temperaments recognised and have their future aspirations addressed. In plans for residents in House 5, there is reasonable detail about resident’s support needs and how their continuing support should be managed. ELP’s for residents in House 2 contain similar detail and the procedure is being extended to cover all residents. It is thought that a different home might provide a more appropriate longer-term service in one case. In another, a resident may be at the stage where supported accommodation may be a better option. Independent advocacy contributes to these decisions. Members of staff in House 5 are pursuing improvements for the comfort and protection of residents. They have identified that appropriate hoists are necessary because of the frailty of residents and extensive training in safe movement and handing of vulnerable people is required. First-aiders will make decisions whether to call an ambulance or carry out appropriate lifting of residents who fall. From information in essential life plans, it is likely that too many oxygen cylinders are stored and the possible over-use of oxygen may not be in the interests of particular residents. Members of staff have flagged up their concerns in writing and the home manager and centre manager need to address these important concerns. Where male residents currently must visit high street beauticians to have their nails cut, it was agreed that staff should carry out this activity. In this context, members of staff quite properly are taking an equalities and diversity issue into account. Each essential life plan includes risk assessments pertinent to the resident. The examples discussed address safety issues whilst aiming to maintain good qualities of life. Members of staff are aware of current policy issues and good practice developments. A deputy home manager outlined how members of staff are transferring this thinking into the daily work of support staff so that the actions of residents are understood in all circumstances and reasons for action/reactions taken into account. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12-17. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Routines and activities developed with each resident give them opportunities to develop their skills and exercise preferences on a day-to-day basis. EVIDENCE: The promotion of each resident’s right to live an ordinary and meaningful life is central to the home’s aims and objectives. Members of staff understand the importance of enabling residents to achieve their goals, follow their interests and be integrated into community life and leisure activities. Residents are able to enjoy a full and positive lifestyle with a variety of options to choose from. Residents’ interests and abilities are known and reviewed. These are taken into account when planning routines of daily living and arranging activities both on the premises and the community. Routines are flexible and residents make choices in major areas of their life. Residents say that staff pressures sometimes mean that fewer choices are available. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 13 Routines, activities and plans are resident focused, regularly reviewed, and can be quickly changed to meet individuals changing needs and wishes. The availability of MPV-type vehicles assists with this flexibility. Residents reported some difficulties with having an adequate number of drivers. The ability of staff to understand what residents mean and feel, despite the lack of some resident’s ability to verbally communicate, also benefits residents and enables routines to be varied. Typed activity lists are used in some houses and pictorial charts are used in others. Members of staff encourage and provide imaginative and varied opportunities for residents to develop and maintain social, emotional, communication and independent living skills. Members of staff outlined methods that focus on involving residents and promote their rights to make informed choices. This includes links to specialist support when needed and opportunities to develop and maintain family and personal relationships. There is evidence of innovative methods being used. This includes prediction of factors that may cause upset to residents and ways of alleviating future distress. The evidence is that residents enjoy the opportunities that they experience. Residents are helped to be independent and are involved in all areas of daily living. This includes taking some part in and responsibility for shopping, upkeep of their House, planning meals, and meal preparation. Residents have menu planners (with workshop produced pictures in some cases). They have access to the restaurant, restaurants outside the premises and in each residential home. It is believed that restrictions placed on residents are subject to review to ensure these are appropriate and are not generalised with other residents affected as a consequence. Many residents have paid or voluntary work on-site and elsewhere. A respondent to the CSCI survey regretted the winding up of a woodwork workshop. Another said that agency staff sometimes do not know enough about the specific support needs of residents. Some said that, although they are caring and work hard, staff have not received sufficient support in understanding some more complex learning disabilities. A respondent referred to occasional poor communications between relatives and senior staff. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18-21. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents receive good personal and healthcare support. EVIDENCE: Efficient medication policy, procedure and practice guidance has been developed. A locked medicine cupboard is maintained in the hub administration block for day care visitors. Each resident in Houses 2, 3, 4 and 5 has a locked medicine cupboard in their room. In some cases, residents may maintain their own medicines subject to regular recorded risk assessment. Staff update MAR sheets after each administration. All members of staff with responsibility for any aspect of medicine administration complete the NCFE Safe Handling of Medicines certificate (which a house manager reported as a highly effective course). Residents receive effective personal and healthcare support. An information file that accompanies the resident’s essential life plan file is maintained as part of monitoring these aspects of resident support. ELP’s (which are under development for all residents) record their personal and healthcare needs and outline how these will be delivered. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 15 Members of staff ensure that personal support is flexible, consistent, and is able to meet the changing needs of residents. They know and respect resident’s preferences. Male, female and age related issues are taken into account when delivering personal care. On this occasion, members of staff responded sensitively in situations involving personal care ensuring that they were conducted in privacy. Residents receive good healthcare support. This includes access to a GP, mental health nurses and all NHS healthcare facilities in the local community. Regular appointments are seen as important and systems are in place to ensure they are not missed. The home arranges for health professionals to visit residents at home when necessary and residents also attend health clinics. Additional training in safe movement and handling of frail older people is being introduced in House 5. The service is efficient when caring for residents who are seriously/terminally ill. The home has a detailed policy, procedure and practice guidance to help staff when caring for residents with degenerative conditions and terminal care. Members of staff receive in house training and practical advice and have continuous support and opportunities to discuss any areas of anxiety and concern. Members of staff referred to how they are alert to changes in mood, behaviour and general wellbeing of residents and understand how they should respond and take action. Health action plans are being developed in line with current good practice guidance. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Arrangements for resident consultation, policies and procedures followed by support workers and other staff on-site and staff skills serve to protect residents and keep them safe. EVIDENCE: Residents are protected in many ways including through good recruitment procedures. These include CRB and POVA checks. It is understood that all staff receive information about the various implications of POVA (protection of vulnerable adults) procedures. Each home has a manager, deputy manager and support assistants who monitor resident’s well being. Members of staff have brought a number of concerns relating to the well being of residents to the attention of the residential manager and the evidence is that these issues are being addressed. There are further members of staff providing on-site support who are able to report where residents might be deteriorating or not thriving. Residents made a number of comments about aspects of the service they receive and are encouraged to make their views known. House managers and other staff regard their safety and protection as a priority. The service has a complaints procedure that is easy to understand. Residents and one relative took part in the commission’s survey. Visitors and others are encouraged to make their views about the service known. The company properly investigated the two complaints received earlier in the year. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 17 Policies and procedures for safeguarding adults are available and give specific guidance to staff. These are also included in the induction process. House managers and other staff understand the circumstances that might need reporting to social services or the commission. Some residents help in the recruitment of staff by attending interviews. Monthly resident meetings are held in which they are encouraged to participate. On a national level CARE holds an annual joint resident and staff conference and it is believed there is a resident consultative forum. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28, 30. People who use the service experience excellent quality outcomes. This judgement was made using a range of evidence including a visit to the service. The residential houses and extensive on-site facilities are suitable for the support of residents and day care visitors from other CARE premises in the district. EVIDENCE: Residential Houses 2, 3 and 4 each have nine bedrooms, two of which are on the first floor, and a shared kitchenette/sitting room. House 5 has seven bedrooms all on the ground floor; these premises are designed for the support of older people some of whom may have the on-set of dementia. This house is built around a central courtyard and residents have plenty of indoor walking space. Some bedrooms have been specifically designed for better wheelchair access. Written pre-admission documents claim that the premises have been designed to conform to Disability Discrimination Act regulations. House 5 is likely to have better facilities when appropriate hoisting equipment is added and CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 19 moving/handling training enhanced. Residential premises have a communal kitchen for meal preparation and for making snacks and drinks outside of meal times, a separate lounge for quiet activity, a dining room and quiet room. Each house has clothes washing and drying facilities and a telephone in a private area. The administration building for the company’s regional activities is located at Philippines Close. This includes a facility for assisting residents and their supporters with advice on funding. The Oak Tree Bistro (a catering facility open to the public), Acorns (an eco-friendly horticulture centre providing gardening skills training as well as sales of plants, gardening services and handicrafts to the wider community), day service facilities, four residential premises and a further building (currently used as staff accommodation) are on the site. The Acorns Horticulture Training Centre’s eco-design includes 2 wind turbines, ground source heat pump, solar panels, grey-water recycling and exports power to other parts of the service including residential premises. Facilities for residents and day care visitors include workshop rooms for crafts, skills development, computer work and photography for training and leisure. The premises were clean and tidy and are very suitable for resident care and use by day care visitors, staff and visiting relatives. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents are in the care of experienced and hardworking members of staff who are likely to benefit from better staffing structures and senior management support. EVIDENCE: Some residents referred to pressures on staff as factors that limit their ability at times to listen more closely to them when they have concerns. Two of the four houses have an awake member of staff on duty at night because of the support needs of residents in those houses. Domestic workers are not employed and support workers are responsible for these activities. At 5-6pm during the inspection, members of staff in Houses 3 and 4 were under considerable pressure as residents returned from activities on-site or elsewhere, evening meals had to be prepared, residents carried out activities under supervision according to the published outline and decisions had to be made about evening outings (principally to Gateway social club that evening). Members of staff referred to high staff turnover, the need to rely on agency staff and lengthening their shift times to cover. They also say it is hoped new CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 21 senior managers understand that poor pay levels are contributing to staffing difficulties. Members of staff are encouraged to undertake NVQ Levels 2 and 3 in Supporting Independence. The induction procedure followed is suitable for this staff group and it covers the standards required by the relevant training agency for the care sector (Skills for Care). Members of staff undertake additional training appropriate to the needs of residents at the home. The records seen indicate that very good progress in this area has taken place over the past year. Plans for achieving a full training profile for each member of staff are discussed in formal supervision meetings between the manager and individual members of staff. Because of the relevance of the subject of dementia in this setting, members of staff are encouraged to achieve the RVQ Certificate in Dementia Care. RVQ and NCFE certificated training is provided in important areas; these include dementia care, medication administration and infection control. All new staff complete CARE’s learning disability award framework (LDAF). House managers, deputy managers and team leaders complete the full 4-day first aid award and support workers undertake the appointed person’s first-aid award (both renewable within 3 years). From information obtained on previous inspection visits it is understood that there are good recruitment procedures. CRB and POVA checks are taken up for all staff and volunteers. There is a good induction system and regular recorded supervision is carried out. Some residents assist in the recruitment process. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents have the benefit of living in a home that is reasonably well run even though CARE has experienced difficulty in retaining a registered manager over the past 18 months. EVIDENCE: CARE has struggled over the past 18 months to retain a registered manager. Each of the 4 residential houses has a manager, deputy manager, team leader and support workers. The acting day services manager was in charge at the time of this inspection visit. A new service manager has recently been recruited to manage the full project. The services manager needs the skills and ability to deliver good business planning, a quality assurance and monitoring process to ensure efficient running of the home and effective outcomes for the people who use the service. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 23 Residents are encouraged to articulate their feelings and, despite high staff turnover and pressures on staff, efforts are made to meet resident’s changing support needs. A high priority is given to providing suitable training and personal development opportunities for staff. Members of staff assisted residents to provide comment about aspects of the service to the commission. Through this and via observation during the inspection visit residents are known to receive good care and support. Reference to how residents and relatives are consulted and involved with the running of the project is referred to earlier in this report. The acting day services manager, house managers and a deputy house manager outlined how they work to improve services and provide a good quality of life for residents with a strong focus on equality and diversity issues. There is a strong ethos of being open and transparent in all areas of running of the project. They are aware of current developments and plan the service accordingly. Their skills and knowledge are based on continuous development, gained through training and enthusiasm for the role. In this respect, it is hoped that the new senior managers will give appropriate consideration to reported concerns. The overall project has clear health and safety policies that all members of staff are aware of and are trained to put theory into practice. Safeguarding is given high priority and the home provides a range of policies and guidance to underpin good practice. A house manager indicated that appropriate safety certificates are in place, for example, fire safety records and annual portable appliance checks for all electrical items used by residents. The proactive stance by staff in requiring suitable hoists and better training in lifting frail people is an example of how they are seeking to protect the interests of residents. CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 24 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 2 2 3 3 x 4 3 5 2 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 4 25 4 26 x 27 x 28 4 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 2 34 3 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x 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 3 3 3 3 2 x 3 x x 3 x CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 CARE Edenbridge DS0000064927.V347137.R01.S.doc Version 5.2 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. 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