Inspection on 24/07/07 for Ceshma Care

This inspection was carried out on 24th July 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

Ceshma Care 10/07/06

Similar services:

Hillside

Applegarth

Trevayler Residential Care Home

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 Ceshma Care Ceshma House 80 Rockingham Road Kettering Northants NN16 9AB Lead Inspector Kim Cowley Unannounced Inspection 24th July 2007 1.30pm Ceshma Care DS0000067054.V340750.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 Ceshma Care DS0000067054.V340750.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. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ceshma Care Address Ceshma House 80 Rockingham Road Kettering Northants NN16 9AB 01536 512091 01536 512091 ceshmacare@hotmail.com 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) Christina Smith-Haynes Christina Smith-Haynes Care Home 5 Category(ies) of Learning disability (5), Mental disorder, registration, with number excluding learning disability or dementia (5) of places Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10th July 2006 Brief Description of the Service: Ceshma Care is a small residential care home for up to five adults with learning disabilities/mental health needs. It is situated in a three-storey Victorian house on the outskirts of Kettering close to bus routes, shops, and other amenities. All bedrooms are single and have ensuite facilities. There is a separate lounge and dining room on the ground floor, and a large secluded garden at the rear. The current fees range from £1,100 to £1,450 per week, with additional charges for day care, hairdressing, personal toiletries, and other items and equipment. Inspection reports are available at the home, or can be accessed via the CSCI website: www.csci.org.uk. Further information about the home is available from the Registered Manager. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection that included a visit to the home and inspection planning. Prior to the visit, the inspector spent half a day reviewing information relating to the home. During the course of the inspection, which lasted three hours, the inspector checked the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means the inspector looked at the care provided to two residents living at the home by meeting them; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were examined. The inspector also met the Registered Manager, the Deputy Manager, and a support worker. What the service does well: Ceshma Care provides a service that is flexible and designed to meet the needs of the individual. Residents are encouraged to determine their own lifestyles with the support of a small committed staff team. There is a high ration of staff to residents, which allows one-to-one work to be carried out so residents can pursue their separate hobbies and interests. Each resident has an individual weekly programme of leisure and educational/vocational activities. They are encouraged to get out and about, and to get to know and become part of the local community. A pet dog is kept at the home, which the current residents are fond of and help to look after. The premises are comfortably furnished and homely. Residents have chosen the décor in their rooms and are proud of how they look. One resident said ‘I like my bedroom. It’s more of a bedsit really. I have a shower and a television.’ Those areas inspected were clean and well maintained. All staff interviewed were professional, caring and knowledgeable about the work that they do. They demonstrated a thorough knowledge of the residents in the home and how best to meet their needs. Residents made the following comments about the staff, ‘The staff have a chat and a laugh with me every day’, and ‘The staff are very good.’ Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Ceshma Care DS0000067054.V340750.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 Ceshma Care DS0000067054.V340750.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): Quality in this outcome area is excellent. Residents’ needs are fully assessed prior to admission to ensure the home is suitable for them. This judgement has been made using available evidence including a visit to this service. (Standard 2 was inspected.) EVIDENCE: The Manager assesses all individuals who are interested in coming to the home. Assessments are needs based, factual, non-judgemental, and focus on the positive. They include details of a person’s educational/vocational background and aspirations. Assessments by other health and social care professionals are taken into account, as are the views of the prospective resident and their relatives. Records showed the assessment process is thorough and effective, and that the ethnicity and diversity needs of people who are interested in coming to the home are given full consideration. Alterations were made to the premises to suit the needs of one resident currently accommodated there. These were carried out prior to her admission. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. Detailed care plans help staff to identify and meet residents’ needs. This judgement has been made using available evidence including a visit to this service. (Standards 6, 7 and 9 were inspected.) EVIDENCE: The Manager writes all care plans, and once they are established key workers take over this task. Those inspected were detailed and comprehensive. The focus is on residents’ strengths and abilities and how staff can support them in taking more control of their lives. One resident commented, ‘I can do more or less what I want to here. I go to bed when I like.’ Care plans are ‘person centred’ and residents discuss them with their key workers during one-to-one sessions. This helps them to ‘own’ their care plans and take more responsibility for how their care needs are met. The view of other health and social care professionals are included in care plans, and staff at the home work closely with them in providing appropriate care for the residents. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 10 Records showed that residents are encouraged to take responsible risks and staff support them in this, offering them choices within acceptable parameters of safety. Risks are managed positively with the aim of encouraging residents to determine their own lifestyles. Staff are currently advocating for a resident who want to undertake a particular activity judged to be high-risk. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. Daily living and social activities enable residents to lead full lives and grow in independence. This judgement has been made using available evidence including a visit to this service. (Standards 12, 13, 15, 16 and 17 were inspected.) EVIDENCE: Each residents at Ceshma Care has an individual weekly programme of leisure and educational/vocational activities including, for example: • • • • • • • Swimming Music Shopping Cinema Pubs College Day centres DS0000067054.V340750.R01.S.doc Version 5.2 Page 12 Ceshma Care All residents have an annual holiday accompanied by staff. One resident told the inspector about her planned holiday, which she had chosen herself, and said she was looking forward to it. Residents’ friends and relatives are welcome to visit the home at any time. Residents are encouraged to get out and about, and to get to know and become part of the local community. A pet dog is kept at the home, which the current residents are fond of and help to look after. Care staff do the cooking, assisted by the residents where appropriate. On the day of inspection one resident had made a curry, which was going to be served as the evening meal. Menus showed a wholesome and varied diet being provided in the home. Residents’ comments about the food included, ‘The food’s good’, ‘We have healthy food here’, and ‘I like the chicken curry best. We’re having that for tea tonight.’ Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good. Residents’ personal and health care needs are met in the way they want by staff in the home. This judgement has been made using available evidence including a visit to this service. (Standards 18, 19 and 20 were inspected.) EVIDENCE: Residents’ care needs are set out in their care plans, and personal care is provided in line with their wishes and requirements. In discussions residents said they were happy with how their needs were met and felt they were treated with dignity and respect. Staff help residents to live as healthy lives as possible. One resident has a ‘Health Action Plan’ and the other an annual health check with a GP. A range of health care professionals provide services to residents including GPs, district nurses, occupational therapists, consultants, physiotherapists, chiropodist, dentists and opticians. Records showed that residents’ health has improved since they have been in the home and that appropriate aids and adaptations are in place. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 14 Medication is supplied by the home’s contract pharmacist, who also provides staff traning and advice where necessary. All staff, unless they are on induction, administer medication. The Mananger oversees the safe keeping of medication and checks records to ensure it has been properly administered. At present no residents self-medicate. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. Staff know how to safeguard residents and help them express any concerns they might have. This judgement has been made using available evidence including a visit to this service. (Standards 22 and 23 were inspected.) EVIDENCE: The home’s complaints procedure is available in a user-friendly format. The Manager said it is also made clear to residents verbally how to complain and staff will advocate for them if necessary. A resident commented, ‘If I wanted to complain I’d tell the staff.’ There have been no complaints since the home opened. The Manager said that all staff are trained during their induction in safeguarding adults (see also Standard 35), and know what to do if abuse is suspected. They also attend safeguarding training provided by the local authority, and safeguarding is a regular agenda item at the monthly staff meetings. This helps to ensure that residents in the home are protected from abuse, neglect and self-harm. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. Residents live in an environment that community-based, comfortable, and well maintained. This judgement has been made using available evidence including a visit to this service. (Standards 24 and 30.) EVIDENCE: The premises comprise of a spacious Victorian family house with many original features. Communal rooms are comfortably furnished and homely. Residents have chosen the décor in their rooms and are proud of how they look. One resident said ‘I like my bedroom. It’s more of a bedsit really. I have a shower and a television.’ The ground floor is accessible to residents with physical disabilities. The front door is alarmed to alert staff if a resident leaves the premises unaccompanied. There is a secluded garden to the rear of the home which residents can help to maintain. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 17 Since the last inspection the following improvements have been made to the home: • • • French windows have been fitted in the dining room to give residents safe access to the garden A new bathroom has been created on the ground floor The lounge has been redecorated The Manager said she is in the process of purchasing a portable ramp to make access to the rear garden easier for residents with physical disabilities. All areas inspected were clean and well maintained. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is excellent. Friendly and professional staff meets residents’ needs. This judgement has been made using available evidence including a visit to this service. (Standards 32, 34 and 35.) EVIDENCE: At present a Manager, Deputy, and a small team of support workers are employed, although the Manager said staff numbers would increase as more residents come to live at the home. All staff interviewed were professional, caring and knowledgeable about the work that they do. They demonstrated a thorough knowledge of the residents in the home and how best to meet their needs. Relationships between residents and staff were seen to be excellent. Residents made the following comments about the staff, ‘The staff have a chat and a laugh with me every day’, and ‘The staff are very good.’ Staff files were inspected and found to be well organised and complete. Each contained a checklist to ensure all the necessary documentation has been obtained when a member of staff starts work at the home. The recruitment of appropriate staff helps to ensure residents are safeguarded. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 19 All staff have a 10 days induction period. Records are kept to confirm they have achieved competency in each area they receive training. Induction records were inspected and it was noted there is no separate competency for safeguarding. While it is recognised that staff at Ceshma Care do receive training in safeguarding, it is recommended that this be made a distinct topic in the induction programme. When staff have completed their induction they go on to take NVQs (National Vocational Qualifications) and the majority have Level 2 or 3. Further Training is provided both in-house and externally. All staff have supervision with the Manager at least every two months. New staff have supervision once a month during their six months probationary period. This helps to ensure that staff have a good understanding of their duties and responsibilities in the home. Staff meetings are held once a month. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is excellent. The home is well managed with the focus on empowering and enabling residents. This judgement has been made using available evidence including a visit to this service. (Standards 37, 39, and 42 were inspected.) EVIDENCE: The Manager is a qualified social worker with considerable experience of caring for adults with learning disabilities. Her management approach centres on enabling and empowering residents so they can live as independently as possible, whilst remaining safe. This is evident in the homes documentation, and in discussions with residents, staff and the Manager herself. Either the Manager or the Deputy is on call to staff at the home 24/7. Quality Assurance systems are currently informal and consist of weekly residents’ meetings where those attending are encouraged to air their views about the home and get involved in the way it is run. The Manager said that in Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 21 future she hopes to introduce a residents’ questionnaire so their views can be formally recorded. Records showed that the health, welfare and safety of residents and staff is a priority in the home. Appropriate checks and servicing of equipment has been carried out, as has consultation with the home’s Fire and Environmental Health Officers. Staff are trained in health and safety during their induction. The premises have been risk assessed and are non-smoking, although residents are allowed to smoke in the garden with staff supervision where necessary. Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 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 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X Ceshma Care DS0000067054.V340750.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA23 Good Practice Recommendations ‘Safeguarding’ should be made a distinct topic in the home’s induction programme. This will help to highlight the importance of this area of staff responsibility. 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