Inspection on 25/11/05 for Cartref House

This inspection was carried out on 25th November 2005.

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

Cartref House 28/06/07

Cartref House 28/02/06

Cartref House 08/02/05

Cartref House 16/07/04

Cartref House 15/03/04

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

CARE HOME ADULTS 18-65 Cartref House Cartref House 22 London Road Sittingbourne Kent ME10 1NA Lead Inspector Sarah Montgomery Announced Inspection 25th November 2005 09:30 Cartref House DS0000023921.V265800.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 Cartref House DS0000023921.V265800.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. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cartref House Address Cartref House 22 London Road Sittingbourne Kent ME10 1NA 01795 428447 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) care@cartrefhomes.co.uk Mrs Brenda Joyce Tyler Mr Robert William Tyler Mr Anthony Ian Vallis Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2005 Brief Description of the Service: Cartref is a semi-detached property with accommodation on three floors, bedrooms being on the first and second floors. All rooms are single occupancy and have television points. It offers accommodation and support for 6 young adults with learning disabilities, with the emphasis on assisting them to move towards a more independent life style. Services are individually tailored to meet the needs of the service users, offering opportunities to develop their skills as is appropriate. The home is situated on the busy A2 leading into Sittingbourne, with shops and other local amenities within easy walking distance. It is on a bus route and there is a main line railway station approximately a quarter of a mile away. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this announced inspection on November 25th 2005. The majority of the inspection was spent talking to service users. This included reading through care plans with individuals, reading through the service user guide, and general discussion about services and facilities at the home. The inspector read a selection of records pertaining to all service users (daily notes, care plans, meeting minutes). Discussions were also held with the Manager, and with care staff. The duration of the inspection was 5 hours. What the service does well: What has improved since the last inspection? Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 6 Cartref continues to review and evaluate working practice, policy and procedures to ensure the services and facilities provided to service users remain at the highest standard. 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. Cartref House DS0000023921.V265800.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 Cartref House DS0000023921.V265800.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 and 4. Service users can be confident that their individual needs and aspirations are appropriately assessed and met, and equally confident that they are given ample opportunity to visit and ‘test drive’ the home. EVIDENCE: The inspector spoke to a service user who had recently moved into the home. They spoke about what happened prior to the move, how the service user had settled in, and what the staff at the home had done and were doing to help that process. To assist in this the service user shared all assessment documentation and care planning paperwork with the inspector. The home’s service user guide was also read by both inspector and service user. The service user described how she was assisted in choosing the home by her care manager and her family. She said that they had received the service user guide and statement of purpose and liked the sound of Cartref. Someone from Cartref visited her, and as well as asking her a lot of questions, they told her more about the home and the people that live and work there. They also spoke about the kind of things she might do if she lived there. Following this the service user visited the home, had a look around and had the opportunity to talk to service users and staff. The file contained very detailed assessments pertaining to the service user. On speaking with the service user about these, she confirmed that they described her accurately, and was very happy with the care plans, especially as they not Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 9 only recognised her current needs and abilities, but looked beyond them and had targets for her to work towards. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Service users know their assessed and changing needs, make decisions about their lives, and are supported to take risks. EVIDENCE: A group of service users spoke individually and collectively to the inspector about their life in the home. All service users spoke warmly of the staff team, and indicated they valued the help and assistance given by staff in achieving goals and making decisions. Of the care plans viewed, all contained detailed assessments, which were in date and reflected current needs of service users. All care plans are reviewed every six weeks, or more frequent if necessary. Evidence on files supported this frequent review, and demonstrated that changing needs are recognised and responded to. One service user expressed frustration at limitations that had been placed on him and were written into his care plan. However, he also acknowledged that he signed up for the limitations (risk assessments), agreed with them, and felt safer for having them in place. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 11 Service users described the processes in which they are supported to make decisions. For decisions which are personal to them, and affect only their life, this is usually made or discussed with their keyworker, but sometimes involves the home manager and care manager. Decisions affecting everyone living in the house (cleaning, cooking, group trips out) are discussed and made either in formal house meetings, or over dinner, or a chat over coffee. The service users gave a strong indication to the inspector that decisions are democratic, with everyone having their say, and although it can get quite lively and heated, everyone has their say and outcome is always positive. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 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): 12, 13, 16 and 17 Service users can be confident that by living at Cartref they will have opportunities for personal development, will be part of the local community, will have their rights respected and responsibilities recognised, and can be assured of a healthy diet. EVIDENCE: The inspector spoke with a number of service users, staff and management regarding lifestyle opportunities at the home. Care plans, daily notes, and individual timetables were looked at. Service users described an environment in which they felt very supported individually, indicating that the staff team understood their needs and continually encouraged them to fulfil all their goals. They also spoke about living with a group of people, and how good and sometimes how difficult that could be. They gave an impression of caring for their housemates, and indicated that compromise and working things out fairly is part of everyday living at the home. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 13 One service user spoke in detail about her life in the home, informing the inspector of a range of activities she partakes in – both in house and in the community. It was clear from talking to service users, staff and reading care plans and daily notes, that all service users receive a very individual and well planned service which is entirely based around assessed needs and personal goals. Staff are highly aware of individual needs, and will research not only appropriate activities, but will strive to locate the best facilities, even if this means travelling over 30 miles to college – because classes are smaller and the service user will receive better teaching and attention. Service users spoke of their families and friends. The home supports all service users to keep in contact with their friends and family by assisting them to arrange visits, write emails, and use the telephone. All service users take part in a cooking rota. This involves cooking for the group one night a week, and cooking a meal for themselves one night a week. The service user cooking is responsible for menu planning and shopping. They are supported by staff when necessary, and are encouraged by staff and other service users to cook a nutritious and balanced meal. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19. Service users benefit from having care plans which detail their personal support needs. Service users further benefit from having a competent staff team who ensure through assessment that individual physical and emotional health needs are met. EVIDENCE: All service users have care plans which detail assessed needs in relation to personal support. These care plans are accompanied by teaching targets which are linked to goals. Service users are supported and encouraged to be as independent as possible in the home, this includes personal support. The inspector could see that service users are constantly challenged to move forward in their lives, and that this challenge takes place in a supportive environment. If service users are struggling with any stage of the teaching routine, then a reassessment and adjustments are made. Observations of staff interacting with service users evidenced a staff team competent and knowledgeable about the emotional needs of service users. Conversations with service users were natural and flowing, and the inspector noticed that responses from staff to service users were measured, thought out, and mirrored specifics noted in care plans. The art of conversing in such a way is a difficult skill to achieve, and staff can only be praised for interacting so Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 15 naturally with service users while clearly following directions for agreed responses. In addition to this, Cartref will, when necessary, ensure that service users receive support from healthcare professionals regarding physical and emotional health. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22. Service users can be confident that their care is enhanced by an open, transparent and accessible complaints procedure. EVIDENCE: Service users explained the complaints procedure to the inspector. They displayed awareness of staff roles, and who the key people are to talk to if they had a complaint or concern. From discussion with service users it was clear that concerns or complaints are aired either in general everyday discussions over dinner, or in house meetings. Service users feel comfortable with talking to their keyworker, and will mainly use this route to discuss worries or complaints. They indicated that they would freely talk to any staff, including the manager, but recognised the special relationship with their keyworker and felt natural in turning to them. The inspector asked service users if they were happy with the response from keyworkers or staff regarding complaints. All service users indicated they felt listened to and valued by staff, and were satisfied with responses to complaints. Most complaints are dealt with informally – by talking things through and coming to a resolution, which is acceptable. However, service users are aware that complaints can be formal, and can include written notes, and involve care managers and other professionals. All service users said they prefer to sort out complaints informally, but would be confident to explore the formal route if necessary. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 17 Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 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, 25, 26, 27 and 30. Service users benefit from living in a home, which is comfortable, safe, homely and clean. EVIDENCE: Two service users showed the inspector around the communal areas of the home, and their bedrooms. It was clear that the service users felt ‘comfortable’ and ‘at home’. They certainly displayed a sense of ownership, which only comes from truly feeling that where you live is ‘your home’. Service users have spent time and effort thinking and deciding about the décor and furnishings. The lounge has been recently redecorated and refurnished and reflects the tastes and ideas of all the service users. Bedrooms are personalised and comfortable, and service users are encouraged to make them into havens of personal space. All members of the house – both staff and service users, respect this space. People only go into other service users rooms if invited. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 19 Bathrooms are decorated nicely and are clean and welcoming. Doors have locks and windows are covered. All areas of the home presented as clean and hygienic. Service users have a well-planned cleaning rota, and are supported by staff in undertaking these tasks. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 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): 32, 33, and 34. Service users benefit from being supported by staff who are clear about their roles, and are competent and qualified, and are protected by the home’s robust recruitment practice. EVIDENCE: The inspector spoke to staff about their roles and responsibilities at the home. Staff talked about working in an enriching, supportive and creative environment in which their needs and skills as staff members are recognised and responded to by the management team. They described a detailed induction programme, which included a mix of practical work in which shadowing of shifts took place, and of reading policies, procedures and care plans. During induction, training needs are identified and all staff are expected and supported to undertake relevant training, including NVQ training and training specific to the service user group. Service users spoke highly of the staff team, indicating that they felt they were being supported by a group of staff who understood them, respected them, believed in their aspirations, and would do all they could to assist them in leading fulfilling and enriching lives. Inspector observations on the day echoed the comments of service users. The inspector sampled staff files. All files looked at evidenced a thorough recruitment procedure, which fully protected service users from harm. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 21 The inspector has recommended that the Home Manager is involved in future staff interviews. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 38. Service users benefit from living in a well run home, whose ethos, leadership and management approach is transparent and accessible. EVIDENCE: The home has recently had a change of manager. She is an experienced manager, having managed another home in the Cartref group. Wendy Sheppard has continued to uphold and promote the policies, procedures and good practice which makes Cartref a home which is focussed on the needs of service users, and which continually strives for excellence in service delivery. The manager was present throughout the inspection, and displayed in depth knowledge of the service user group, of individuals within that group, and of management skills required to manage a staff team, and skills needed to bring all the knowledge together to translate them into a home which people want to live in, and is forever evolving and changing in response to service users. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 4 4 4 x Standard No 22 23 Score 4 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 4 X 4 x Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 3 3 X X 3 LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 X 16 4 17 Standard No 31 32 33 34 35 36 Score X 4 4 4 X X CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cartref House Score 3 4 X X Standard No 37 38 39 40 41 42 43 Score 4 4 x X X X X DS0000023921.V265800.R01.S.doc Version 5.0 Page 24 No 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. 1 Refer to Standard 34 Good Practice Recommendations The Home Manager is involved in the recruitment and selection of new staff. Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cartref House DS0000023921.V265800.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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