Inspection on 21/06/06 for Conifers

This inspection was carried out on 21st June 2006.

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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Conifers 25/07/08

Conifers 02/08/07

Conifers 02/12/05

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 21st June 2006 09:30 Conifers DS0000059959.V293857.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 Conifers DS0000059959.V293857.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. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 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.V293857.R01.S.doc Version 5.1 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 2nd December 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. The Registered Providers supply information to prospective service users through a variety of routes. These include the provision of a Service Users’ Guide. This is a brochure which outlines the principal features of the facilities and services available in the Home. Also, the Registered Providers ensure that a copy of the most recent Inspection Report from the Commission, is available for reference in the Home. The Registered Providers have informed the Commission that the current range of fees they charge for residence in Conifers runs from £324.36 to £477.98 per week. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Report has been based upon a number of sources of evidence. These included a review of the correspondence in relation to the Home received by the Commission since the last inspection. Another source of evidence involved any written information received from service users, from their relatives and from social workers (care managers). Also, the Inspector completed an unannounced site visit to the Home. This took about six hours to complete. During this time, the Inspector spoke in some detail with four of the service users. Some of these discussions were in private. The Inspector also joined a number of the service users for lunch. The Inspector spoke with the Registered Manager and with two the support workers. The Inspector examined various parts of the accommodation and he reviewed a selection of the key records and documents. The Inspector concludes that the Registered Providers generally operate the Home so as to provide the service users with access to the resources they need to enable them to lead normal everyday lives. However, there are some omissions which might detract from the adequacy of the support received by service users. These now need to be addressed. There are five Required Developments at the end of this Report. With respect to these, the Registered Providers should submit to the Commission a written Action Plan. This should state what has been done and what will be done to ensure that the Registered Providers comply fully with the Required Developments specified in this Report. The Commission should receive this Action Plan by 1 September 2006. What the service does well: Service users said that the Home provides them with a relaxed and generally comfortable setting within which to make their home. They observed that they receive all the assistance they need. Also, they said that the support workers are attentive and kind in their manner. The Inspector thinks that there are enough staff around to enable service users’ routine needs for assistance to be met. Also, he was impressed with the confident informality which characterised the interactions he observed between the support workers and the service Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 6 users. The catering arrangements were noted to be adequate. Suitable systems were in place to ensure that the service users take medication in the correct manner. The Inspector noted that the service users are consulted about relevant aspects of how their home is run. What has improved since the last inspection? What they could do better: The Registered Providers should in consultation with the service user concerned, revisit the adequacy of the calendar of vocational/social activities from which he can choose. This is important because there are some indications that more opportunities might be useful and welcomed. The Registered Providers should correct some defects in the decoration of the lounge and in one of the bathrooms. This is necessary because the items in question are unsightly and detract from the overall homely standard achieved. The Registered Providers should complete a review of the adequacy of the knowledge and skills each of the current support workers can invest in the completion of their duties. This is important because as was noted above in relation to the induction of staff, it effects directly the quality of the care which can be provided for the service users. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 7 The Registered Providers should strengthen further a particular aspect of the fire safety system operated in the Home. This is important because the exercise in question will enable the Kent Fire and Rescue Service to better advise about any improvements which may be needed to the arrangements that are in place currently. The Registered Providers should ensure that there is a current certificate which confirms that the Home’s electrical wiring service has been inspected and that it has been confirmed as remaining in a serviceable condition. This is important because electrical faults can result in fires and in other untoward events. 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.V293857.R01.S.doc Version 5.1 Page 8 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.V293857.R01.S.doc Version 5.1 Page 9 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): 2 and 3. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. There are systems in place to ensure that prospective service users and their representatives have their needs assessed. EVIDENCE: The Inspector noted that there had not been any new admissions to the Home since the last inspection visit. Therefore, it was not possible for him to assess the practical application of the various systems adopted by the Registered Providers to establish the suitability of the Home for prospective service users. However, he noted that the Registered Manager is aware of the need to give this matter careful consideration. This is so that a new service user’s needs for support, can be met reliably from the start of their period of residence. The Registered Manager was observed to be familiar with the principal subjects to be considered. It was noted that the Registered Providers have prepared a form which has been designed to guide and to record the process. The Registered Manager said that he informs support workers about the needs of new service users by asking them to read the information he has collected. Also, that they are asked to review information received from the relevant care manager (social worker). In addition to this, he said that he briefs support workers orally so that they can clarify any points of detail as may be Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 10 necessary. The support workers confirmed this account and they said that they consider themselves to have been informed adequately about the needs of service users admitted in the past. The Inspectors asked one of the service users about the arrangements made for him when he moved into the Home. He considered that his needs for assistance had been met from the start and that this provision had been in line with his expectations. The Registered Manager said that he is confident that the current team of support workers based in the Home, has the range of skills and knowledge necessary for it to support the service users in residence. The Inspector noted broadly evidence which was consistent with this account. The Registered Manager was noted to be aware of the various sources external to the Home from which specialist advice can be sought, should the need arise. The Inspector reviewed evidence which showed that some of this advice had been accessed by the Registered Manager in a timely manner since the last inspection visit. The Commission has not received since the last inspection visit, any expressions of concern from the various local mental health services about any aspect of their working relationships with the Home. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 11 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. The health and personal care which service users receive, is based upon their individual needs and is appropriate. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The Inspector noted there to be various systems in place to enable each service user to liaise with support workers in order to identify and to plan for the provision of the assistance they need. These measures include the preparation for each person of a written individual plan of care. The service users said that they had been involved adequately in the preparation of their individual plans and also that they had been invited to contribute to their occasional review. The Inspector examined selected elements of two of the plans to see if particular items had been considered in adequate detail. He concluded that the level of detail was adequate, given how the Home works in practice. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 12 The Inspector noted that the support workers keep diary records of how things are going in the Home. These records are important because they can reveal patterns in how someone is doing which can be useful both for the person concerned and for support workers. The Inspector examined a selection of the entries, some of which were noted to be rather brief. However, the support workers were able to give a much more detailed account and plainly they carry successfully a lot of information in their heads. There is a balance to be struck here about the amount of this information which needs to be recorded. The Registered Manager will need to keep this matter under active review. The Inspector spoke with support workers about various elements of the support provided for some of the service users. They were noted to have an adequate knowledge of the material in question. The Inspector observed episodes when they assisted some of the service users. Their practice was noted to be appropriate and to be consistent broadly with the Registered Providers’ assessment of the needs to be met. The Inspector understand that none of the service users are assisted directly by the Registered Provider to administer their financial affairs. What assistance they do receive, is provided by family and by advocates. It is a good idea to keep these functions separate like this, so that registered providers do get involved in more areas of a service user’s life than is necessary. The Registered Manager has been asked by one of the service users to retain and disburse his weekly personal spending allowance. The Inspector examined the records of the various transactions in question and found things to be in order. The service user said that he remains satisfied with the arrangement. The Registered Providers are responsible for assisting the service users to avoid undue risks to their wellbeing. The Inspector noted that the Registered Providers use a system which involves each service user liaising with support workers to identify potential risks so that they can be managed effectively. The Inspector examined a selection of the written records which summarise this process. In general, they were found to describe an adequate arrangement. This, in that particular risk situations were identified and in that basic information was given about the response to be provided. The Inspectors noted that some of the elements of some of the risk assessments seemed to have been completed informally without being recorded as such. The Inspector accepts that not everything can or should be written down. However, the Registered Providers will need to keep under review the adequacy of the balance achieved in the Home. This, to ensure that organised provision has been made in relation to significant risks. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 13 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): 12, 13, 15,16 and 17. Quality in this outcome area is adequate. This judgement is made using available evidence including a visit to this Service. Service users are able generally to choose their life style, social activities and to keep in touch with family and friends. Service users receive a healthy and varied diet according to their requirements and choice. EVIDENCE: Most of the service users undertake a range of activities each week, some of which have an explicit vocational element. The service users who spoke with the Inspectors about this matter, said that they are satisfied in general with their respective calendars of activities. The Registered Manager said that for each of the service users there is a written calendar which lists the commitments they have chosen to attend most weeks. The Inspector examined the calendar for Service User A, within the context of the need to have a sensible balance between doing things and being at home. He thought that rather more opportunities could have been offered. The Registered Manager has been asked to speak further with the service user Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 14 concerned and to liaise with his care manager about this matter. The Registered Providers should complete this Required Development within the timescale established in the Required Development at the end of this Report. The Inspector noted that most of the service users leave the Home regularly in order to do various things such as going to shops and visiting friends. The service users said that they are satisfied with the degree to which they can access the local community if they wish to do so. The service users said that support workers assist them to keep in touch with members of their families. This includes helping them to use the telephone and to engage in written correspondence. The Inspector reviewed the circumstances of the service user who presently has the least such contact. He is satisfied that the Registered Manager has kept the matter under review and that the service user in question remains content with the contacts that are available to him at the moment. The service users said that the support workers are kind and approachable in their manner. Also, they observed that support workers are not intrusive and that they respect their needs for private space. During the course of the inspection visit, the Inspector had the opportunity to observe a number of instances when support workers interacted with service users. He noted these events to be characterised by a quiet but confident informality. The Inspector recognises this to constitute good care practice. This is because it acknowledges service users’ simultaneous needs both for independence and for support. The service users said that they are provided with suitable meals. The Inspector joined some of them for lunch and he noted that the meal served was adequate in quantity and quality. The meal time itself was a relaxed affair with service users dining at their own pace. There was no sense of them being rushed or overly organised. The Registered Manager said that the Registered Providers give the Home sufficient funds to purchase supplies. The record of food provided in the Home was consistent with the Registered Manager’s account to the effect that the service users are offered the opportunity to have a normally balanced diet. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 15 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. Service users’ emotional, physical and health care needs are met. Service users are assisted to take medicines in the correct manner. EVIDENCE: The service users said that the pace of daily life in the Home is relaxed without there being any unnecessary rules to disturb their experience of a normal domestic setting. They observed that within reason, they can decide on the pattern of their day. They spoke about things such as them being free to decide when to retire to their bedroom and choosing what clothes to wear. The Registered Manager said that the support workers keep a tactful eye open so that service users can be assisted to seek and to follow medical advice should it be needed. The Inspector reviewed the arrangements which had been implemented since the last site visit to assist one of the service users to access medical attention. He noted that suitable provision had been made available to ensure that the person concerned attended various medical appointments. Also noted, was the way in which support workers had monitored discreetly his health in between times. The Inspector noted that the Commission has not Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 16 received since the last inspection visit, any expressions of concern from the local primary health care team about its working relationship with the Home. The Inspector noted that all of the service users have elected to have support workers retain and dispense their medication. The Inspector thinks that this is a sensible arrangement given the interests of the people concerned. The Inspector examined a selection of the administrative arrangements operated by the Registered Providers in relation to this task. They were noted to work well, so as to ensure that service users take medicines in the manner intended. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 17 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. Service users have an effective complaints procedure and they are protected from abuse. 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 said that they are confident that any matter they raise will receive serious attention and that if possible they will be addressed. The Registered Manager said that the Registered Providers operate various systems which should enable all complaints to be investigated promptly and fully. The Inspector noted that the Registered Providers had not received a formal complaint since the last site visit. Therefore, it was not possible for him to determine how well these systems will work in practice. The Commission has not received any complaints in relation to the Home, since the date of the last inspection visit. The support workers were noted to have a reasonable understanding of what constitutes good care practice. As part of this, they were aware of the need to be alert to instances which might jeopardise the well-being of a service user. None of them said that they had witnessed anything in the Home since the last inspection visit, which had given them cause for concern. Also, none of the service users said that they had come across anything which had worried them. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 18 The service users said that they feel safe living in Conifers. They observed that they are confident that support workers will act in their best interests. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 19 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, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. The physical layout of the Home enables service users to live in a generally well-maintained and comfortable environment, which promotes independence. EVIDENCE: Service users said that they are comfortable living in Conifers. The Inspector noted that in general the accommodation was welcoming and pleasant. However, there were some exceptions which detracted from the overall homely feeling of the accommodation. In the ground floor bathroom, the linoleum floor was damaged and looked unsightly. Also, there were areas where the painted plaster finish on the walls was scratched or missing. The hinges on the toilet seat were discoloured. The Inspector noted that one of the doors leading to the main lounge had a damaged finish to one of its faces and again it looked to be most unsightly. This and the other defects noted above, should be addressed within the timescale established in the relevant Required Development listed at the end of this Report. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 20 The Inspector understands that the Kent Fire and Rescue Service in the past has said that the Registered Provider has installed sufficient equipment in the Home to help prevent the occurrence of a fire safety emergency and to respond effectively to one should the need arise. However, this assessment now needs to be updated. To do this, the Service needs to receive from the Registered Providers’ their own evaluation of how potential fire safety risks are to be managed. This is important because the level of fire safety protection available in the Home, depends in part upon how potential hazards are identified and eliminated or managed. The Registered Providers should address this matter within the timescale established in the relevant Required Development listed at the end of this Report. The Registered Manager said that none of the service users currently in residence, do not experience significant difficulties with getting about the Home. More generally, the Registered Manager said that the Registered Providers are aware of the need to keep the subject of service users’ mobility under active review. This is because the premises have not really been designed around the mobility needs of the older people in residence. The Inspector noted that the Home complies currently with the principal requirements of the local Department of Environmental Health. This means that the kitchen is equipped and used appropriately. The service users said that support workers assist them to put their clothes in the washing machine, to dry them and to iron them. The Inspector noted that the service users were dressed appropriately in clean clothes of their own choice. The Inspector examined the laundry facilities. These were noted to be adequate given the size of the Home. All residential care homes now need to comply with revised regulations which have been introduced to help better ensure the purity of drinking water. In particular, the new provisions are intended to prevent water syphoning back from items such as washing machines into the main pipe-work. The Registered Manager was not sure if this work had been completed. It was agreed that the Registered Providers by 1 September 2006, will seek clarification from their water supply company about what if any additional installations are now required. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 21 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. Service users are assisted by support workers who are appropriate people who are skilled suitably. EVIDENCE: Of the eight support workers employed in the Home, two have acquired a National Vocational Award in health and social care. This Award is designed specifically to offer support workers the opportunity to confirm elements of good practice and to extend the range of relevant skills at their command. The Registered Manager said that all newly appointed support workers will be encouraged and helped to study for the Award. The Inspector welcomes this commitment, while acknowledging that some of the existing members of staff do not at present want to work towards the qualification. There are two support workers on duty during the day until the evening period, when the night time cover arrangement starts. Service users said that staff are always around whenever they need them. Support workers commented that there are sufficient staff available in the Home to enable service users to receive the assistance they need. The Inspector considers the Home to be staffed adequately. However, he notes that additional staff resources may be needed to underpin a possible extension to the calendar of activities for Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 22 Service User A, which was mentioned above in relation to Standard 12. The Inspector noted also, that there are not any domestic or catering staff employed in the Home. This means that the support workers have to spend some of their time completing these duties. The Registered Providers should keep this situation under review. This, with a view to determining if these ancillary services would be delivered best by additional members of staff. The Registered Manager said that the Registered Providers complete all of the checks specified in the Regulations. However, the Inspector could not verify this because there had not been any new appointments made since the time of the last inspection visit. The checks in question are important. This is because they are one of the means by which the Registered Providers can ensure that only suitable people are trusted to have unsupervised access to service users who may be vulnerable. The Registered Providers deliver introductory training for all new support workers. This is done to ensure that they have the skills and knowledge they need in order to work without direct supervision. This is important because the competencies possessed by support workers, largely determine how well they are able to assist service users. The Inspector noted that the training system had been strengthened by the adoption of anew national model which the Commission recognises to represent good practice. However, in the absence of any new appointments since the last site visit, he was not able to check how the new arrangement will work in practice. 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 the model noted above. The Registered Providers should complete this exercise within the timescale established in the relevant Required Development listed at the end of this Report. The Registered Manager said that the Registered Providers consider each of the support workers to have the knowledge and the skills they need in order to able to respond to the present service users’ needs for assistance. The Inspector did not identify any practical evidence which contradicted this account. The Registered Manager said that he meets informally with each of the support workers in order to review their work and to sort out any problems, should there be any. This is important because support workers need to have the opportunity to reflect upon their work and to work towards resolving the problems which will crop up inevitably. The support workers said that they consider themselves to be free to speak with the Registered Manager, who they think is helpful and knowledgeable about residential care provision. The Inspector thinks that it would be wise to make the supervision arrangements a little more organised, so that the sessions are held on a planned basis. The Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 23 Registered Manager has said that this will be done once the knowledge and skills review exercise noted in relation to the preceding Standard, has been completed. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 24 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): 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. The promotion of health and safety is effective generally. There is a quality assurance system. EVIDENCE: The Inspector noted that the Registered Manager continues to administer the Home in an appropriate manner, so as to help the support workers to coordinate their efforts in a reliable manner. This is very important because it means that service users can experience consistent support regardless of who happens to be on duty in the Home. The Registered Manager has acquired formal qualifications which the Commission recognises as confirming his possession of competencies which are key to effective management. As noted earlier in this Report, the service users said that the support workers consult them about various aspects of the day to day running of the Home. The Inspector noted that the Registered Providers complement this largely informal arrangement, by asking service users to complete an annual Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 25 questionnaire. The results of this exercise are then summarised in a Quality Report which is available for service users to consult and upon which they can comment. The Registered Manager said that the Registered Providers are going to consider further what additional methods can be used to consult with service users. This is a good idea because questionnaires tend to not be popular and so often do not get completed fully. The Registered Providers were noted to have completed the various routine checks which have to be undertaken to ensure the continued operability of the Home’s fire safety equipment. Also, they operate a system which is designed to ensure that all of the support workers know how best to avoid the occurrence of a fire safety emergency and how to respond to one should the need arise. This is very important because the actions taken by staff determine largely the level of fire safety protection available in the Home. The Registered Manager said that all items of equipment in use in the Home remained in good working order. The Inspector sample checked some of the paperwork relating to this matter and he found it to confirm the Registered Manager’s account. The Inspector did note that there was not written confirmation about the current serviceability of the Home’s electrical wiring service. It is important that the service be re-inspected periodically. This is because it has a limited life and failures can cause fires and other accidents. The Registered Providers should address this matter within the timescale established in the relevant Required Development listed at the end of this Report. The Registered Manager said that there were not any significant risks to health and safety in the Home. The Inspector did not notice any obvious hazards with which to contradict this account. Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 26 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 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 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 3 30 2 STAFFING Standard No Score 31 X 32 2 33 3 34 X 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 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 3 X 3 X X 3 X Conifers DS0000059959.V293857.R01.S.doc Version 5.1 Page 27 No Are there any outstanding requirements from the last inspection? YA24 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 YA12 Regulation 12 Requirement The Registered Providers should in consultation with Service User A review the adequacy of the weekly calendar of vocational and social activities from which he can choose. The Registered Providers should correct the defects in the accommodation noted in relation to the main lounge and in relation to the ground floor bathroom. The Registered Providers should submit to the Kent Fire and Rescue Service, a suitably detailed written assessment of the way in which they propose to manage potential risks to fire safety in the Home. The Registered Providers should complete an organised and recorded assessment of the adequacy of the skills and knowledge each of the support workers can invest in the personal care they provide for the service users. The Registered Providers should ensure that the Home’s electrical wiring service has been DS0000059959.V293857.R01.S.doc Timescale for action 01/12/06 2 YA24 23 01/12/06 3 YA24 23 01/09/06 4 YA35 18 01/01/07 5 YA42 23 01/01/07 Conifers Version 5.1 Page 28 inspected in accordance with the relevant part of British Standard BS7671. Any improvements specified in the report of the inspection visit, should be completed. 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.V293857.R01.S.doc Version 5.1 Page 29 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.V293857.R01.S.doc Version 5.1 Page 30 - 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. 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