Inspection on 28/06/07 for Cartref House

This inspection was carried out on 28th June 2007.

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 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 28/02/06

Cartref House 25/11/05

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 Tina Thomas Key Unannounced Inspection 28th June 2007 10:00 Cartref House DS0000023921.V336717.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 Cartref House DS0000023921.V336717.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. Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 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 Cartref Homes UK Ltd Mr Robert William Tyler Wendy Margaret Shepherd Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2006 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. Current fees are: £1319 per week. Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. It was conducted over a one- day period. The manager was not present during inspection, however the Registered Individual was available. The inspection process consisted of information collected before and during the visit to the home. The inspector spoke with staff and people that live in the home to seek their views. Other information seen included care plans, and staff records. What the service does well: What has improved since the last inspection? The homes Statement of Purpose and Service User Guide has been updated to ensure that prospective residents have current information regarding the home. Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 6 The manager has ensured that infection control procedures have improved by placing liquid soap and paper towels in areas such as the laundry room. All staff now have adult protection training. 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. The summary of this inspection report can be made available in other formats on request. Cartref House DS0000023921.V336717.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 Cartref House DS0000023921.V336717.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): 2 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People planning to move to the home have their needs fully assessed prior to moving into the home. EVIDENCE: The home has updated its Statement of Purpose and Service User Guide, which inform people of what can be expected on a day to day basis at Cartref House. Each person that chooses to live at Cartref House has undergone a full holistic assessment to ensure that the home is suitable for them, and that their needs will be fully met. Care managers complete an assessment of needs to inform the home of what care they will be expected to deliver. The manager and staff at the home communicates with a variety of health care specialists involved with peoples care to ensure that placements will be successful. Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 9 Cartref House DS0000023921.V336717.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 outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans are generally clear and concise. They guide staff as to how to best meet peoples needs. People are encouraged and supported to make their own decisions. Staff approach risk management in a positive manner, which allows people to meet their potential. Suitable risk assessments are in place. EVIDENCE: Each person that lives in the home has a plan of care. The information from the care managers assessment and homes assessment is used to produce a Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 11 care plan. The care plan describes how each person likes to be looked after. It also looks at any risks that may be involved in people meeting their goals or through their behaviour. People living in the home can take part in the planning of their care if they choose. Some people said that they didn’t want to be involved in that, but they knew what was written about them. The plans were mostly well written, well maintained and well reviewed. However, one plan viewed, described a restriction of choice for one person. An activity that the person enjoyed had been restricted to an hour. Whilst the reasoning for this was clear in the plan, the decision making process regarding how an hour was decided as a time limit, and the reviewing of the time limit i.e. when could it become for example 1hour 15 minutes was not clear. Some parts of the care plan are pictorial, which is more suitable for some people living at the home. People at the home are encouraged to make their own decisions. Staff were observed to support people in their decision making. People at the home look after their own finances as far as they are able with the support of the staff team. Risk assessments were well documented and enabled people to achieve goals and to have new experiences. Cartref House DS0000023921.V336717.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): 11,12,13,14,15,16,17 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported and enabled to take part in a wide range of meaningful activities, both for educational and leisure purposes. Routines within the home are flexible so as to support people’s active lives. People are encouraged and supported to be part of the local community. Regular contact with family and friends is encouraged and supported. Service users are offered a healthy diet. EVIDENCE: Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 13 Staff help people at the home to find suitable occupations and meaningful activities. People’s activities are mapped out on a weekly pictorial planner. People at the home attend college and have taken part in courses such as computer studies, pottery, life skills and words and numbers. Several people at the homework, for example work in a shop, cleaning and a paper round. This assists with the homes community links and social inclusion. People at the home take part in lots of age appropriate activities and interests. These include going to the gym, swimming, and bowling, horse riding, shopping, ice skating, trampoline and pub visits. The home has a car, which enables people to take trips out. There have been two recent group holidays. People at the home maintain family links. One person talked about going to their mother’s house for a visit. People are able to have visitors at any time and can see their visitors in the privacy of their own rooms or in the communal areas. Daily routines in the home are flexible. People living there are encouraged to take some responsibility for their day. People can make their own lunches. People living at the home said the food was nice. There is a varied menu. People at the home are sometimes involved in the preparing or cooking of meals. People can help themselves to hot and cold drinks. Cartref House DS0000023921.V336717.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): 18,19,20 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Personal support needs are detailed, and encourage people to increase independence. Physical health needs are generally well met. Medication management needs to be improved. EVIDENCE: People in the home said that they liked the way they were supported by staff. Everyone has a key worker. Guidance and support for each person is described in their care plan. One person was having time alone with the Registered Provider to talk privately. Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 15 Any personal care or support is given in privacy in people’s own rooms or in the bathroom. Care plans very clearly indicated input from other healthcare teams such as district nurse and specialist teams such as psychologists. Staff administering medication are trained by the manager. It is unclear whether the manager is trained to deliver this type of training and what the content or quality of the training is. Medication administration records are well maintained. Medication sheets explain what medication is for and any contraindications. Some people at the home are capable of administering their own medications but have not been given the opportunity. Some people had looked after, and administered their own medication prior to living at the home. They should be supported in retaining this skill. The medication policy shold describe the protocol for medication when people go away or when medications are given incorrectly, so that staff know how to act accordingly. Cartref House DS0000023921.V336717.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 outcomes in this area. This judgement has been made using available evidence including a visit to this service. People at the home know that they can complain and that their complaints will be taken seriously. Staff endeavour to protect the dignity of the people living at the home. EVIDENCE: The home has an appropriate complaints procedure. People living at the home understood that they could make a complaint and believed that they would be listened to. One person spoken with said that people at the home could speak with their key worker, or the Manager. All staff have training regarding adult abuse. The manager is a trained trainer in this subject. Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,30 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is fit for purpose and clean throughout. EVIDENCE: The home is comfortable, clean and homely. Furnishings and fittings are domestic in nature. Each person has their own room, which are well decorated and personalised with people’s own belongings. All bedroom doors are lockable and people can have their own keys if that is appropriate. Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 18 The home is clean throughout and soap dispensers and paper hand towels have been placed in the laundry and communal washing areas to promote infection control. Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff received the support and supervision they needed to provide good care to service users. EVIDENCE: Observation of staff indicated that they were kind and caring. They had a good understanding of peoples needs. People that live at the home indicated that the staff were accessible and approachable. Discussion with staff showed that they had a good knowledge of the people living in the home and their conditions. All staff at the home have a suitable induction and foundation training, which is inline with Skills for Care. 62 of staff are trained to NVQ Level 2 or above and others are completing NVQ training. Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 20 Staff files showed that the appropriate pre-recruitment checks had been conducted. The home has all of the documentation regarding staff required by Schedule 2 of the Care Homes Regulations 2001. This helps to ensure the safety of people at the home. Current recruitment processes involves people living at the home in the process of selecting new staff that work in the home. Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well managed. People that live in the home are supported to be involved in the development of this service. Generally the health, safety and well being of those that work and live in the home are protected. EVIDENCE: Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 22 The manager is registered with the Commission and has completed a ‘fit person’ interview. The home is run in a competent manner. The home has a number of quality assurance processes, which very much include seeking the views of people that live in the home. There are regular meetings for people that live in the home. Other tools include reviews of care plans, staff meetings and regular 1-1 supervision. The home has a development plan. Environmental risk assessments were regularly conducted to ensure the safety of service users. With the exception of medication practices, the manager generally ensures the health and safety of people working and living in the home. Suitable training is in place for staff. The home is well maintained. The manager complies with relevant legislation. Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 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 3 2 3 3 x 4 x 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 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 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 1 x 3 x 3 x x 3 x Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 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. 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 YA20 Good Practice Recommendations The medication policy should clearly identify the procedure for action to when medication is taken out of the home. It should also document the action to take if medications are given in error. People that are able to self medicate should be supported to do so Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 Page 25 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 Cartref House DS0000023921.V336717.R01.S.doc Version 5.2 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. 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