Inspection on 23/10/07 for Chatting Independently Ltd

This inspection was carried out on 23rd October 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chatting Independently Ltd 04/06/09

Chatting Independently Ltd 30/01/07

Chatting Independently Ltd 31/05/05

Chatting Independently Ltd 06/10/04

Chatting Independently Ltd 04/05/04

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

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

CARE HOME ADULTS 18-65 Chatting Independently Ltd 3 Rectory Drive March Cambridgeshire PE15 9QR Lead Inspector Neil Fernando Unannounced Inspection 23rd October 2007 11:15 Chatting Independently Ltd DS0000047884.V354401.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 Chatting Independently Ltd DS0000047884.V354401.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. Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chatting Independently Ltd Address 3 Rectory Drive March Cambridgeshire PE15 9QR 01354 650767 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) david@chattingindependently.co.uk Chatting Independently Ltd Anthony Scott Robertson Care Home 6 Category(ies) of Physical disability (6) registration, with number of places Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 service users who are learning how to use an Augmentative Alternative Communication System (AAC) 30th January 2007 Date of last inspection Brief Description of the Service: Chatting Independently Ltd. is situated in a converted bungalow at 3 Rectory Drive, which is a private road near to March town centre. The service is specifically designed to cater for 6 people with a physical disability, who will be learning how to use AAC (Augmentative Alternative Communication aid), which is an electronic device to assist people with speech communication problems. There are six single rooms and residents share the kitchen/dining area, bathroom and lounge facilities. A good size well equipped physiotherapy room is now available. The hydrotherapy pool is almost complete. There are landscaped gardens to the rear of the property. A separate training/treatment room is situated in the home. There is an office and sleeping-in facilities for the staff. A copy of the last inspection report was in the office and available to residents and families. The fee levels vary depending on the needs of individuals accommodated; the current fees for the services range between £1,850 and £2,700 per week. Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We, the Commission for Social Care Inspection, undertook this unannounced key inspection on 23 October 2007. We had an opportunity to speak with three residents and five members of staff including a senior care staff, and the financial director. We had a look round the building and viewed a range of records the home must keep, and observed staff care practices. There were six residents accommodated with no vacancies. We received a completed AQAA (Annual Quality Assurance Assessment) – a document, which gives the manager the opportunity to tell us how the agency is meeting the standards and regulations. Surveys (Questionnaires) have been sent to relatives and staff to seek their views about the service. These were not available at the time of the inspection; any feedback would be included in the next inspection report as appropriate. The registered manager was on leave; the director of finance was in charge of the home and was present throughout the inspection. What the service does well: The home has achieved a good standard of specialist support for people with a physical disability, who are learning how to use AAC (Augmentative Alternative Communication aid) – an electronic device to help people with verbal communication difficulties. The home has a good assessment system in place, which is both detailed and comprehensive in its approach to identifying all the needs of new and existing residents. The staff team are both committed and enthusiastic in their approach to people who can present as very challenging and demanding. The residents are involved in their care planning; this has produced a personcentred plan that enables staff to offer an individual service, in order to meet each person’s needs and aspirations. Staff and residents’ interactions indicate that there is a good rapport between each other. The environment continues to be developed and improved to provide a homely setting in which people can live safely and lead lifestyles that suit them. In particular, the bedrooms are well presented and have suitable furnishings and décor that both promote the residents’ dignity and provide a good level of comfort and individuality. The training needs of staff are being identified and addressed on an ongoing basis. Staff have received all mandatory training, which ensures they carry out their roles effectively and safely. Chatting Independently Ltd DS0000047884.V354401.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. Chatting Independently Ltd DS0000047884.V354401.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 Chatting Independently Ltd DS0000047884.V354401.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): Standards 2 and 4 Quality in this outcome area is good. The home makes sure it can meet people’s needs by getting detailed information about them before they are offered a place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most of the residents have lived at this home for a number of years; indeed, there has been only one new admission to the home since the last inspection. Care files for three people including the latest admission show that when the home receives a new referal, a detailed assessment of needs is completed. We learn from the person in charge and staff members that each prospective resident is invited for a one day visit, to discuss the services offered at this home. This is then followed up by a 3 day visit when they are assessed by the home physio, speech, language and occupational therapist. Care staff also assist the person during the time they spend at the home. At this stage, an individual care plan is also drawn up, based on the care plan/information available from where the person has come. Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 9 A comprehensive pre-admission assessment is undetaken and the home is careful to only offer a place to the resident whose needs and aspirations it can meet. Chatting Independently Ltd DS0000047884.V354401.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): Standards 6, 7 and 9 Quality in this outcome area is good. Detailed care plans ensure that residents receive the necessary care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were examined and were found to contain a good level of information on how the people wish to live their lives. The care plans cover a full range of personal, health, emotional, social and cultural/spiritual needs with clearly defined actions for staff to follow. They are broken down to dayto-day life including all aspects of how the people wish to spend their day. Residents are consulted in the drawing up of the care plans and are encouraged to have active lifestyles. Records show that each resident has their care plan reviewed six monthly. Residents also have an annual review each, which are undertaken by the care Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 11 manager from the placing authority. Minutes of reviews indicate that staff seek to involve residents in all aspects of their care. Where risks have been identified, residents and staff have information about how this can be managed. Risk assessments had been carried out for all residents; these are updated as necessary. Chatting Independently Ltd DS0000047884.V354401.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): Standards 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. The residents are encouraged to choose their activities and to be involved in developing their social skills for independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Everyone takes part in their own choice of activities, either individually or in groups. The activities and outings that each person takes part in is recorded in the care plan. Daily living activities are written in the care plan as goals. The staff respect people’s privacy and support the residents to be as independent as possible. For example, we saw one person in his room and he said that he tidies his own room and takes part in shopping and cooking with staff assistance. He later went out to the town with a staff to buy paint to decorate his room. Five of the residents have their own computers in their own Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 13 room. Two residents attend a local church weekly. Evidence shows that residents have one to one support and all have access to a good variety of activities suitable to their needs. The home has two cars and one minibus, which are used for transportation. Staff said that these are very helpful to take residents out on various activities. The residents are encouraged to maintain family contacts and enjoy positive relationships with others, inside and outside the home. Each person is given an amount of money to purchase her/his weekly food. This enables the residents to develop social skills for independent living. Each person is assisted by a member of staff to plan their own menus every week, go shopping and then help in the preparation of the meal. Chatting Independently Ltd DS0000047884.V354401.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): Standards 18, 19 and 20 Quality in this outcome area is good. The staff members offer good quality personal care and treat the people who live in the home with sensitivity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living at this home have a range of complex physical needs, as well as communication difficulties. Consequently, their personal and health care requirements are often very extensive. The care plans had been reviewed on a regular basis and amended as required. Detailed recording of each person’s personal and health care is maintained on each shift. Entries made had been signed for but this was less consistent between the day staff members. The senior care staff on duty was aware of this difficulty and agreed that this needed addressing. All residents are registered with local GP services. Other people the residents have access to include local health professionals as well as buying in services for example, physiotherapy and occupational therapy. The hydrotherapy pool Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 15 being built would also be a valuable resource to residents. The registered manager uses the communication aid and he undertakes training in independent living skills; the responsible person is a qualified speech and language therapist. There are safe systems in place to support residents who take prescribed medication to ensure it is stored and given in line with the GP’s written instruction. The staff who administer medication have undertaken training and their competency has been assessed and is kept under review. Chatting Independently Ltd DS0000047884.V354401.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): Standards 22 and 23 Quality in this outcome area is good. The policies and procedures on complaints and adult protection protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The procedure on complaints was available. Staff spoken with demonstrated a good understanding of what is expected of them when a complaint is received. A complaints record is maintained; there were no complaints recorded since the last inspection in January 2007. We have received no complaints. The home has satisfactory procedures concerning adult protection and whistle blowing. 50 of the staff have received training on adult protection provided by the local social services adult protection team. Arrangements were in hand for the remaining staff to complete their training as well. The staff members spoken with are aware of the procedures for reporting any allegations of abuse. There were no adult protection matters pending at the time of the visit or any staff members referred to the POVA and POCA registers. Chatting Independently Ltd DS0000047884.V354401.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): Standards 24, 25 and 30 Quality in this outcome area is good. The home provides a comfortable and well - maintained environment for the residents, and the staff maintain a good standard of cleanliness. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is furnished and decorated in domestic styles that produce a homely and comfortable environment that allows the residents to relax, and feel very much at home. A variety of aids and adaptation are available to meet the needs of people in residence. The lounge and Kitchen/diner are also domestic in style and are comfortably furnished and well equipped. The residents all have their own rooms, arranged and decorated to suit their particular interests and tastes. The home was recently extended and now offers an extra bedroom and a physiotherapy room. In addition, a hydrotherapy pool is being built, which Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 18 should be completed soon. Risk assessments of the physical environment are in place and reviewed regularly. The home was clean, fresh and generally well maintained; there were no mal odours. Staff follow appropriate procedures to maintain hygiene and prevent the risk of infection. Chatting Independently Ltd DS0000047884.V354401.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): Standards 32, 33, 34, 35 and 36 Quality in this outcome area is good. The home has an enthusiastic team of staff who have the training and skills to deliver a good quality of care for the residents but the recruitment procedures must be more robust. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Considering the needs of the people accommodated at this home, a high ratio of staff is required to offer a one to one support to each person. The staffing rotas showed that there are six care staff throughout the day, from 7am to 10.00pm and one member during the night. One person also sleeps in to provide extra support if needed. A member of the management is on call to provide support and guidance in case of an emergency. The staffing arrangements are satisfactory to ensure that the needs of the people accommodated could be met. Staff receive induction that covers mandatory health and safety training. Records and information from staff show that a “good level of training is being Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 20 provided on a wide range of subjects”. Thus ensuring all staff members have the necessary knowledge and skills to carry out their role efficiently. The personnel files for two members of staff were seen. Each contained evidence that references and CRB/POVA checks had been undertaken before they began their employment. However, a second reference was not available in either case. The director of finance who was in charge of the home on the day of the visit was aware that action was required on this issue. Staff spoken with said that staff meetings are held monthly and they have good opportunity to raise any issues. It is positive to note that the manager has improved the supervision system; all staff now receive regular supervision. Chatting Independently Ltd DS0000047884.V354401.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): Standards 37, 39 and 42 Quality in this outcome area is good. The staff team are being supported and managed well. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents spoken to were happy and comfortable in their environment. The relationship between the people accommodated and staff is well balanced with interactions observed being sensitive and supportive. The management approach of the home endeavours to create an open and positive atmosphere; staff spoken with said that they feel supported and the home is well managed. “Very good management support”, said a member of staff. The registered manager and responsible person work closely with the residents and staff Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 22 team. A clear commitment is made to equal opportunities with staff expressing positive views with regards to this. Evidence shows that the views of those using the service are sought and acted upon. This quality monitoring system should be further developed, perhaps using questionnaires to include the views of all interested parties such as relatives, care managers and significant other professionals. Any feedback received should be taken into account when improving and developing the service. A number of records in relation to health and safety were viewed (including fire, emergency lighting, fridge/freezer and electrical appliances): these were all in good order. Records viewed also showed that staff had undertaken training in moving and handling, infection control, food hygiene and fire safety. Cleanliness in the kitchen was very good and all foodstuffs were stored correctly. Health and safety issues that were noted include the following: • • Hot water temperatures in the bathroom and shower facilities had not been tested. Tests of break-glass points had been carried out but this had not occurred weekly in July and September 2007. All risks to residents’ health and safety identified under this standard must be removed so that residents are protected from possible harm. Chatting Independently Ltd DS0000047884.V354401.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 X 2 3 3 X 4 3 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 x 27 x 28 x 29 x 30 3 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 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 x 3 x 2 x x 2 x Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 24 Yes 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. 1. Standard YA34 Regulation 19 (1) (b) (i) Requirement Two written references must be obtained before any employee commences work, to ensure the protection of residents. (An outstanding requirement since 28 February 2007). The quality monitoring system should be further developed, to include the views of relatives, care managers and significant other professionals, for the purpose of reviewing and improving the quality of service. i) Hot water temperatures in the bathroom and shower facilities must be tested and recorded regularly to ensure that there is no risk of scalding to the people who live in the home; ii) Tests of break-glass points must be undertaken weekly. Timescale for action 15/12/07 2. YA39 24 31/01/08 3 YA42 13 (4) (a) & (c) 30/11/07 Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 25 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 YA18 Good Practice Recommendations Staff completing the daily records of personal and health care provided should also include their signature. Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Chatting Independently Ltd DS0000047884.V354401.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!