CARE HOME ADULTS 18-65
Chamberlain Way, 17 17 Chamberlain Way Surbiton Surrey KT6 6JH Lead Inspector
Claire Taylor Unannounced Inspection 17th February 2006 12:45p Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 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 Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 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. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Chamberlain Way, 17 Address 17 Chamberlain Way Surbiton Surrey KT6 6JH 020 8399 8254 020 8399 7653 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) Royal Borough Of Kingston Upon Thames Jane Elizabeth Wells Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Staffing must be provided to meet the assessed needs of all service users. The levels of staffing will vary according to assessed needs and occupancy levels with a minimum of one member of staff on duty at all times. Nighttime support should be adjusted to reflect assessed needs. Minimum staffing at night must be one waking member of staff. The Registered Manager is also registered to manage Woodbury, care home for 15 adults with a learning disability. A qualified, competent and experienced person, other than the Registered Manager, shall be employed to oversee the day-to-day operations of the home. The organisation must ensure that the above minimum staffing levels remain under review and that at all times suitably qualified, competent and experienced persons are working in the home in such numbers as are appropriate for the health and welfare of service users. 12th October 2005 2. 3. 4. 5. Date of last inspection Brief Description of the Service: 17 Chamberlain Way is owned and managed by the Royal Borough of Kingston and provides respite care for up to three adult service users with learning disabilities. The period of stay offered can range from an overnight stay to a number of months, dependant upon the service user’s needs. The home caters for service users of both sexes aged from 18-65 years. The home is part of the Woodbury Community Housing Project, a group of houses linked through management and service provision. Two of the homes within the project are also registered with the Commission for Social Care Inspection. The home is located next door to one of these, namely Woodbury and retains strong links with the service. The Registered Manager oversees operations in all units, and is based mostly at Woodbury. As a condition of the registration of Chamberlain Way, a senior member of staff has been employed to manage the day-to-day operations of the home. There is a large garden to the front and rear of the home. Accommodation for the service users is provided in single bedrooms with a communal lounge, dining area and kitchen. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was the home’s second for the year 2005/2006. It was arranged by advance notification so that staff records could be checked as they are currently held centrally by the owning organisation. The visit began at 12.45pm and lasted just over three hours. The inspection focused upon the requirements and recommendations made, and those standards which were not assessed at the last inspection. The registered manager and deputy facilitated the inspection. Towards the end of the visit, two service users and one staff were met upon their return to the home. Two visiting relatives also spoke briefly with the inspector when they called in. All those who contributed are thanked for their time. The home received a positive report for the previous inspection (October 2005) and has once again showed consistency in its application of the National Minimum Standards as well as a commitment to improve upon quality of care for the service users. What the service does well: What has improved since the last inspection?
The home is commended for addressing all the previous identified areas for improvement. Care plans, known as “my support plan” have been introduced for the service users. These set out well how staff should help people to meet their needs and achieve the things they want to do and plans are formatted in a more personalised way. A photograph of each service user is now kept on their respective files. A written maintenance and redecoration programme has
Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 6 been put in place that shows how the home keeps the premises in a good state of repair and plans for home improvements. The service users individual risk assessments have been revised and define more clearly where any restriction is in the person’s best interest. The health, safety and welfare of people living and working in the home are better safeguarded. I.e. Risk assessments related to safe working practices have been defined more clearly and hot water temperature checks are now carried out regularly to ensure that they are maintained at the safe limit. Improvements have been made to the Service User’s Guide and statement of purpose so that all the necessary information is available to prospective service users and their representatives. 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. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 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 Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 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): 1 and 3 Improvements have been made to the Service User’s Guide and statement of purpose so that all the necessary information is available to prospective service users and their representatives. The home continues to accurately assess, identify and meet the needs of the people who come to stay for respite care. EVIDENCE: The home has revised its Statement of Purpose and Service Users Guide so that it contains all the required information. Full details of the homes complaints procedure and how to contact the Commission for Social Care Inspection are now included. Both documents are written in a format that is accessible to service users and contain photographs and pictures of the accommodation provided. Copies of needs assessments were on file for each service user as well as detailed needs assessments completed by their placing authorities. I.e. undertaken by their care managers. Content of the assessments was detailed and person centred to the service user’s individual needs. This provides staff with comprehensive information about the individual and how they should be supported. A detailed assessment was available for the most recent service user. Records showed that the service user had received appropriate support to settle in. In addition, the service user’s relative spoke positively about the home and good service provided. Staff have received specialist training on epilepsy to enable them to fully support those service users with such needs. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 The care planning process is well managed and ensures a personalised and consistent level of service provision for the people staying in the home. Risk taking assessments have been improved so that service users are provided with the necessary support and independence is maximised as far as possible. EVIDENCE: The personal goals and needs of the service users who come to stay are frequently discussed, recorded and actioned. Since the last inspection, the home has implemented Person Centred Planning. Known as “My support plan” the plans detail what each service user likes to do each day, the things that they like and how the staff should best support them to achieve their personal goals. Daily records of care directly relate to the assessed needs and goal plans identified in each service user’s plan. These were comprehensive and detailed how the service users’ identified health, personal and social care needs would be met, and for example how staff should support a service user in their personal care, or respond to behaviour that may challenge the services they require. As previously required, service users risk taking assessments have been reviewed. A risk assessment tells the staff how to make sure that each of the service users is kept safe from anything that might harm them
Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 10 whilst protecting their individual rights and choice and maximising their independence. Examples seen included safety in the home, managing personal care and accessing the local community. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 17 Planned around their needs and preferences, service users benefit from a choice of recreational activities and fulfilling lifestyle both within the home and local community. Meal provision reflects variety and choices, whilst seeking to maintain a healthy lifestyle for service users. Standards 12, 15 and 16 were assessed as met at the October 2005 inspection. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 12 EVIDENCE: When the service users come to stay, they are encouraged to maintain their usual routines, as they would normally do with their main carer. Some service users attend day centres, college classes and community activities organised by the home. Service users attend independently or with the support of staff where necessary. A list of planned events and activities for the forthcoming year is also sent to the service users so that they can plan their choices when they come to stay at the home. Forthcoming activities include theatre and restaurant trips, sightseeing in London, cinema and house activities such as art and craft hobbies. Recent events have included a themed weekend where a beautician visited the home to provide service users with treatments such as facials, manicures and head massage. As well as the neighbouring home’s own transport; service users regularly access public transport services including buses and trains. The menus at Chamberlain Way are centred on the likes and dislikes of the service users and planned each day. An alternative to the main meal is provided as well as accurate records kept of daily meal choices made by the service users. Records showed that the service users who stay at the home are independent in eating and do not require assistance, but support is available if required. On return from their day care centre, two service users were supported to prepare themselves a cup of tea and choose a snack. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Medication is well managed to maintain maximised good health for the service users. Standards 18 and 19 were assessed as met at the October 2005 inspection EVIDENCE: Each service user has a written profile to specify what medication is required together with a homely remedy policy, authorised by the individual’s GP. Medication administered is recorded and kept in each service user’s file. Staff receive medication training through the Kingston Borough training department. New staff are inducted through their in-house orientation on the safe administration of medication. The medication is stored in individual service users’ bedrooms in a lockable facility. Robust policies and procedures are in place on medication practices. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 14 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 Arrangements for dealing with complaints are well managed to ensure that service users feel listened to and their views are acted upon. Standard 23 was assessed as met at the October 2005 inspection. EVIDENCE: The home has an accessible complaints procedure that meets all the elements of this Standard including a minimum response time of less than 28 days and details of how to contact the Commission. As mentioned earlier in the report, a summary of the complaints procedure has been revised and incorporated into the Service User’s Guide. The home facilitates meetings to enable service users to raise any matters of concern in order that appropriate action can be taken. There is also has a logbook to document any complaints or concerns. No complaints have been made about the home’s operation in the past twelve months. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 15 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 Chamberlain Way is clean, hygienic, comfortably furnished and service users live in homely and pleasant surroundings. Standard 30 was assessed as met at the October 2005 inspection. EVIDENCE: The communal living areas and bathroom were viewed on this occasion. Bedrooms were seen at the last inspection and appropriately furnished and decorated. The environment continues to be kept homely, well maintained and decorated to a good standard. It retains a family type atmosphere and provides comfortable surroundings for the service users who come to stay. As previously required, a written plan for the home’s overall maintenance and redecoration programme has been put in place. Future home improvements include plans to extend the building as a conservatory. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 16 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, 34, 35 and 36 There is a small staff team who have relevant training and support that enables them to meet the needs of the people living at the home. Service users are therefore benefiting from a well-supported staff team who receive regular supervision and guidance. Procedures for the recruitment of staff are robust and provide safeguards for people living in the home. In accordance with regulation, staff records must be kept on site in the home. EVIDENCE: Staffing needs are assessed and provided according to the level of occupancy and individual service users. Minimum staffing at the home is one staff member whilst service users are at the home. Staffing is generally provided from 7am until 10am, then again from 3pm until 10pm during weekdays, and throughout the waking day at weekends. The deputy manages the day-to-day running of the home, supported by regular bank staff who are employed within other homes run by the registered providers. Including the manager and deputy’s, four staff files were sampled. Record keeping was in good order. All new staff who commence work in the home undergo a thorough vetting procedure. This includes a police check (CRB) and a check against the Protection of Vulnerable Adults register. Records confirmed that staff have undergone appropriate checks. Files sampled showed that references have been obtained appropriately and other records including proof of identity and recent photograph. New members of staff complete an induction programme covering various subjects including health and safety, fire drills, and
Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 17 introductions to service users and other staff. The induction programmes are signed, dated and kept on staff files. Support and supervision for staff is good and well organised by the manager; meetings take place monthly and are recorded. These sessions are used to identify what the member of staff does well, what they need to improve upon and what training they may need. Annual job appraisals are also undertaken with staff. The manager had completed a training needs analysis for the staff team in December 2005. Records showed that in-house training has been achieved in all key areas with further training planned throughout the forthcoming year. Examples include person centred care planning, medicine awareness, food hygiene, fire safety and first aid. Manual handling training for staff has been achieved since the last inspection. Staff files are currently held centrally by the owning organisation but as required by regulation, staff records must be kept in the home and a requirement was set for this to be addressed. The Commission has recently developed a “staff proforma” form that should be completed for each employee and kept in the relevant home. The form can be used to evidence that appropriate recruitment checks have been undertaken by the employing organisation as well as other documents required by law. A copy of a blank form was therefore left for the registered manager. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 18 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, 39 and 42 The manager has good experience and professional qualifications relevant to managing the home. Based on service users’ views and other relevant parties, the home needs to develop its quality monitoring systems further to show how they intend to make positive changes and monitor quality of care. Health and safety practices have improved to ensure that people living and working in the home are further protected from harm. EVIDENCE: The Registered Manager, Jane Wells, is a qualified social worker and also has a relevant management qualification. Records and discussion showed that the manager is experienced and knowledgeable about the needs of the service users. The manager is mainly based at the neighbouring residential home, and has worked at the Woodbury Community Housing Project for many years. The deputy manager has responsibility for the day-to-day running of Chamberlain Way. She too is an experienced senior member of staff who has acquired a varied range of training including the NVQ Level 3 qualification in care. Although the home does have some systems in place that serve as a means of
Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 19 quality monitoring, some improvements are still needed to fully meet the standard. Satisfaction questionnaires need to be offered to service users, their families and /or representatives and other professionals. Findings can then be used to monitor how the home is running and if there are any problems. This will also show how the views of the service users, their relatives and other interested parties influence the running of the home. Previous inspection requirements (October 2005) that centred around health and safety practices have been addressed meaning that the health, safety and welfare of people living and working in the home is better safeguarded. I.e. Risk assessments related to safe working practices within the home have been completed. The home has arranged for a contractor to test the water facilities. Checks on hot water temperatures are now carried out regularly to ensure that they are maintained at a safe limit. Other servicing and maintenance records for the home were checked at the last inspection and up to date. The front door, also a fire exit, is kept locked by an electronic keypad access system. Although risk assessments are in place for each service user, the manager needs to develop a locked door policy for the home. Such restrictions could be construed that service users are not fully able to exercise their rights within the home and this must be included in the policy. Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 20 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 X 3 3 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 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 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 X 12 X 13 3 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X 3 X 2 X X 2 X Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 21 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. 1. Standard YA34 Regulation 17(2) Requirement The required staff records must be kept in the home in accordance with Schedule 2 of the Care Homes Regulations 2001. The home must seek the views of service users, their family members / representatives and other interested parties to ensure that the home is meeting its aims, objectives and stated purpose. Results of these surveys must be made available in the home. The manager must write a policy for locking the front door. Timescale for action 31/05/06 2. YA39 24 30/06/06 3. YA42 13(4) 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chamberlain Way, 17 DS0000042884.V284107.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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