Inspection on 02/12/05 for Conifers

This inspection was carried out on 2nd December 2005.

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

Conifers 25/07/08

Conifers 02/08/07

Conifers 21/06/06

Conifers 23/08/05

Conifers 11/10/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 Conifers Conifers 73 Reculver Road Herne Bay Kent CT6 6LQ Lead Inspector Mark Hemmings Unannounced Inspection 2nd December 2005 0930 Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Conifers Address Conifers 73 Reculver Road Herne Bay Kent CT6 6LQ 01227 372112 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) s.kejiou@toucansurf.com Mr Serge Kejiou Mrs Swastee Kejiou Mr Serge Kejiou Care Home 10 Category(ies) of Learning disability (1), Mental disorder, registration, with number excluding learning disability or dementia (9), of places Mental Disorder, excluding learning disability or dementia - over 65 years of age (6) Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. MD (E) is restricted to those persons whose dates of birth are:26.04.1937 19.01.1931 15.12.1926 18.03.1935 17.01.1934 10.07.1931 23rd August 2005 Date of last inspection Brief Description of the Service: Conifers (the Home) is registered to provide accommodation and personal care for nine adults (service users) who have or who have had difficulties with maintaining aspects of their mental health. One of the service users has a learning disability. Of the overall number of service users in residence, up to six may be older people. The Registered Providers are Mr S Kejiou and Mrs S Kejiou. Mr Kejiou has assumed responsibility for the day to day supervision of the Home. It was with him that the Inspector worked during the course of the inspection visit. As appropriate in this Report, Mr Kejiou is referred to as being the Registered Manager. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was announced and it took about three hours to complete. During this time, the Inspector spoke with or spent time with six service users. Also, he spoke with the Registered Manager. The Inspector examined various records and he spoke with two of the support workers. The Inspector looked at various parts of the accommodation. This included (by invitation) three of the service users’ bedrooms. The Home continues to provide the service users in residence with the support and assistance they need. Service users say that they remain satisfied with the provision made for them in Conifers. The Inspector did not review all of the Standards during the present inspection visit. The reader is invited to read both this Inspection Report and the Report of the previous inspection visit in order to obtain a more comprehensive account of the Inspector’s overall evaluation of the Home. There is one Required Development at the end of this Report. What the service does well: What has improved since the last inspection? Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 6 The Registered Providers have addressed a category of omissions in one of the records used to administer medicines which are retained on behalf of service users. Also they have begun a process which is designed to validate that all of the support workers have the competencies they need in order to enable them to provide an effective and reliable response to the service users’ individual needs for assistance. 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. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Prospective service users are given the information they need to make an informed decision about living in the Home. Service users’ needs and aspirations are assessed before they move into the Home. Service users are confident that the Home will enable their needs for assistance and support to be met. Prospective service users have the opportunity to visit then Home before deciding about moving in. Each service user has a written account of their terms and conditions of residency. EVIDENCE: There is a Service Users’ Guide. This is a brochure which prospective service users are given and which outlines the facilities and services provided in Conifers. In addition to this, the Registered Manager speaks with prospective service users to answer any remaining questions they may have. The Registered Manager meets with each prospective service user to assess their needs for assistance. This is done to ensure that these needs can be met reliably in the Home, should the admission proceed. Service users say that they were confident at the point of admission to the Home, that they knew what was on offer and that this would meet their needs. Also, they observed that their expectations of the services they hoped to receive, have been met. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 9 Service users say that they were encouraged to visit the Home at least once before they made a decision to move in. They consider this to have been useful because it gave them a first hand impression of what daily life in Conifers is like. All of the service users have a copy of the contract of residence. This document gives a suitably detailed account of the terms and conditions in accordance with which the Registered Providers deliver accommodation and care services in the Home. The Inspector understands that the Registered Manager takes the time to speak with them about the document in order to answer any questions they may have had about its contents. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Service users are confident that their present and future needs for personal care will be met in a reliable and consistent manner. They are suitably consulted about both the assistance they receive and the day to day running of the Home. Service users are supported in taking prudent risks. EVIDENCE: There is a service user plan for each service user. These documents describe the assistance the service user in question has agreed to receive. The Inspector sample checked several of these plans and he found them to be suitably detailed. Service users say that they are consulted about the contents of the plans and that they are fully involved in periodic reviews of their contents. Service users consider that they receive all the assistance they need. Support workers assist service users in a manner consistent with that described in the individual service user plans. Service users are assisted to take those reasonable risks which are part of everyday living. The Registered Manager is aware of the need to keep this matter under careful review. This is so that service users are assisted to avoid Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 11 situations in which their own welfare or those of others may become jeopardised. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Service users have access to a suitably varied range of social and vocational activities, some of which involve engagement with the local community. Service users are assisted to maintain contacts with family and friends. Service users are enabled to exercise their citizenship rights and to respect those of other people. Service users are offered a suitably healthy diet. EVIDENCE: Service users undertake a range of social and vocational activities. Service users say that they are consulted about what they want to do and that staff assist them to access the necessary resources. The Inspector witnessed a several of these events taking place during the course of the inspection visit. Most of these involved service users leaving the Home in order to go the shops to purchase everyday items such as newspapers and cigarettes. Service users consider their time to be occupied appropriately. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 13 The Registered Manager and the support workers are aware of the need to strike an appropriate balance between engaging with service users and recognising their needs for quiet time. This is an essential element of good practice within the Home. Service users are assisted to maintain helpful contacts with members of their families and with friends who do not live in the Home. Service users say that they are provided with good quality meals and that they always have enough to eat. On this occasion, the Inspector did not join service users for a meal. However, when he last did so he noted the meal served to be of a good standard and to be adequate in quantity. The written menu indicates that the service users are offered a normally balanced diet. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Service users receive assistance and support in a respectful and appropriate manner. Service users’ physical and emotional health care needs are met. Service users are assisted to handle their own medication, when this is appropriate. As necessary, suitable arrangements are in place to enable staff to retain and dispense medication on behalf of service users. EVIDENCE: Service users say that support workers are attentive to their needs without being intrusive. The Inspector witnessed various occasions on which support workers assisted service users. He noted these events to be characterised by a quiet informality which is consistent with good care practice. Service users who have problems with aspects of their physical health are assisted to seek and to follow the advice of their doctor. Staff keep a tactful eye open so that medical conditions are noted at an early point. The Inspector has not received any expressions of concern in relation to the Home from partner agencies such as members of the primary health care team. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 15 The Registered Manager said that if appropriate service users can be assisted to manage their own medication. At the time of the present inspection visit, none of the service users had elected to act in this manner. The Inspector examined selected aspects of the arrangements used by staff to administer service users’ medication on their behalf. He found that suitable practices were in place to store medicines and to ensure that service users take them in the manner intended by their doctor. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Service users consider that their views are listened to and as necessary are acted upon. Service users are protected from abuse, neglect and self harm. EVIDENCE: There is a complaints procedure which explains how service users and other stakeholders can make a complaint about any aspect of the facilities and services provided in the Home. Service users say that they are confident that any matter they raise will receive serious attention and if possible will be addressed. The Inspector notes that neither the Registered Providers nor the Commission is in receipt of any complaints relating to Conifers which remain to be resolved. Support workers have a good understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances which might jeopardise the well-being of a service user. Also, they are aware of how to bring such a matter to the attention of the Registered Manager and/or to external regulatory bodies. Service users say that they feel safe living in Conifers and that they trust members of staff to act in their best interests. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30. The Home provides comfortable accommodation. Service users’ bedrooms are adequately presented and equipped. There is a sufficient number of toilets and bathrooms. There is adequate equipment in place to enable support workers to assist those service users who experience a measure of reduced mobility. The Home is cleaned to a normal domestic standard. EVIDENCE: Service users say that Conifers provides them with comfortable accommodation in which they have been able to make their home. The Inspector noted the accommodation to be presented to a normal domestic standard. There is a split in the panel fitted to the side of the bath in the ground floor bathroom. The Registered Manager said that this defect will be corrected by 1 April 2006. Service users say that they like their bedrooms and that they have all they need in order to use them as bed sitting areas. The Inspector visited three of the bedrooms. He noted them to be comfortable and that they reflected the preferences of their occupants. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 18 There is an adequate number of toilets and bathrooms. All of the people currently in residence are able to get about without much assistance. The Registered Manager is aware of the need to keep this matter under review. This is so that aids and adaptations can be provided should service users’ need them in the future. The accommodation is cleaned to a normal domestic standard. The Inspector examined the kitchen and he noted it to be presented to a suitable standard of hygiene and to be operated appropriately. The Inspector understands that the local Department of Environmental Health has not recommended the completion of any improvements which remain outstanding. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34 and 35. Support workers have a good understanding on their duties and they work together well as a team. There is an adequate number of staff on duty. Support workers have the competencies they need. Appropriate steps are taken to ensure that only suitable people work in the Home. EVIDENCE: Support workers are provided with a written account of their duties. The staff team is relatively stable. This means that people have got used to working together and that service users know who is going to be around and what they are going to be doing. There are handover meetings at the beginning and end of each shift and support workers keep diary records of how things are going for each service user. There are regular staff meetings and support workers say that they are actively consulted by the Registered Manager about how the Home is administered. There are two support workers on duty during the day until the late evening period when the night time cover arrangement starts. Staff say that enough support workers are deployed in the Home to enable an effective service to be provided. Service users say that support workers are always around when they need them. The Inspector considers the Home to be staffed adequately. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 20 However, he does note that no domestic or catering staff are employed in the Home. This means that the support workers have to spend some of their time completing these duties. The Registered Providers should review this situation with a view to determining if these ancillary services would best be delivered by additional members of staff. The Registered Manager provides introductory training for all new support workers to ensure that they have the skills and knowledge they need in order to work without direct supervision. The Inspector understands that the exercise has been strengthened in order to ensure that all of the subjects specified by the Standards are included. The Registered Providers are going to complement this initial tuition by reviewing the adequacy of the competencies possessed by all of the existing support workers. This will be done using a model which has been adopted by the Standards. The Registered Manager said that the exercise will be completed by 1 July 2006. The Inspector considers that the support workers have in relation to the items he sample checked, the competencies they need in order to provide a reliable and effective response to the present service users’ needs for assistance. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. The Registered Manager runs the Home so as to reliably provide service users with appropriate assistance. Service users’ rights and best interests are protected the operation of the Registered Providers’ recording systems and by the implementation of its policies and procedures. A suitable framework is in place to promote the health and safety of service users and staff. EVIDENCE: The Registered Manager has the competencies necessary to enable him to operate the Home in the best interests of the service users. He has begun a course of study which will enable him to acquire the first of two formal qualifications which are required by the Standards. The Registered Manager has a detailed understanding of the day to operation of the Home and of the particular needs of each of the service users. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 22 The Registered Manager maintains various recording systems to assist in the management of the Home. The Inspector notes that there are no patterns in the various entries which indicate the need for him to make any further enquiries. The Kent Fire Service has not recommended any improvements which remain outstanding. The Registered Manager completes the periodic checks which have to be made to ensure the continued serviceability of the Home’s fire safety regime. The Registered Provider does not have in place a system which is designed to validate periodically the competency of all members of staff to avoid the occurrence of a fire safety emergency and to respond effectively to one should the need arise. The Registered Manager said that this matter will be addressed within the timescale listed in the Required Development listed at the end of this Report. The Inspector understands that the Registered Provider has arranged for all appliances such as gas boilers to be serviced in accordance with the manufacturers’ instructions. The Registered Manager said that there are no significant hazards around the premises which could result in someone having an accident. Also, the Inspector did not notice any such hazards. Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Conifers Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 X DS0000059959.V256462.R01.S.doc Version 5.0 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 42 Regulation 23 Requirement The Registered Providers should ensure that all members of staff are included within a suitably specified programme of fire safety competency appraisal. This should check at least once in every period of six months, that all staff are aware of how best to avoid the occurrence of a fire safety emergency and that they are able to respond effectively to one should the need arise (This Required Development is outstanding from the previous Inspection Report and it should have been completed by 01/10/05). Timescale for action 01/01/06 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 Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Conifers DS0000059959.V256462.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!