Inspection on 25/07/08 for Conifers

This inspection was carried out on 25th July 2008.

CSCI found this care home to be providing an Good service.

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 02/08/07

Conifers 21/06/06

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 27/09/2008.

CARE HOME ADULTS 18-65 Conifers 73 Reculver Road Herne Bay Kent CT6 6LQ Lead Inspector Joseph Harris Unannounced Inspection 25th July 2008 10:30 Conifers DS0000059959.V367384.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 Conifers DS0000059959.V367384.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. Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Conifers Address 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 registered manager (if applicable) Type of registration No. of places registered (if applicable) skejiou@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.V367384.R01.S.doc Version 5.2 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 August 2007 Date of last inspection Brief Description of the Service: The home is a detached property set over two floors providing single accommodation for nine adult 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 facilities provided are single bedroom accommodation, and the shared communal space consists of two lounges one for non-smokers and one for smokers. There are also available bath and walk in shower facilities. The home is located in the village of Beltinge. There are local shops within walking distance, and the coastal town of Herne Bay with its seaside attractions and amenities is a bus ride away, or approximately thirty minutes walking distance. 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 have informed the Commission that the current range of fees they charge for residence in Conifers ranges from £343.90 to £495.00 per week. Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key unannounced inspection process culminated in a site visit to the home on 25th July 2008. The site visit commenced at approximately 10.30am and concluded at 3.30pm, lasting for around 5 hours. During the course of the visit a tour of the premises was undertaken and discussions were held with the registered manager, staff members and service users. A range of documentation was examined relating to the residents, staff, medication, health and safety and the day-to-day running of the home. The home also returned the Annual Quality Assurance Assessment (AQAA), which provides information to inform the inspection process. What the service does well: What has improved since the last inspection? The registered manager has addressed all the previous requirements. Care plans and risk management plans are clearly detailed providing good guidance for staff. Plans are reviewed on a regular basis with the involvement of the service user and key worker. Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 6 The statement of purpose and service user guide have both been updated and provide a good level of information for prospective service users. Staff have now completed training in Adult Protection issues and additional training covering the Mental Capacity Act. Training needs in general have been improved and all staff complete the Common Induction Standards and mandatory training in the first 6 months of employment. There are sufficient numbers of staff on duty at all times to meet the needs of the service users. The registered manager stated that some rooms have been redecorated since the last inspection and further environmental improvements are planned once funds have been raised. 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. Conifers DS0000059959.V367384.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 Conifers DS0000059959.V367384.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): 1 and 2. Quality in this outcome area is good. Service users have access to suitable information about the home and have their needs assessed prior to moving in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has updated the statement of purpose and service user’s guide following a previous requirement. These documents were examined and contain all required information about the home. A copy of the service user’s guide is provided to all prospective residents at the point of referral. No new service users have been admitted to the home since the last inspection activity. Sufficient systems are in place, however, to ensure that the needs and aspirations of prospective service users are assessed before moving into the home. The registered manager ensures that Care Programme Approach (CPA) documentation is received including care plans and risk assessments. Joint Care Management assessments were also on file for some residents. An inhouse assessment has been developed and is completed. This covers the full range of needs and has a positive focus on mental health issues. Information is Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 9 gathered from service users, health and social care professionals and any significant others. Conifers DS0000059959.V367384.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): 6, 7 and 9. Quality in this outcome area is good. An individual service user plan is developed for each resident containing support plans and risk assessments. Residents are able to make decision affecting their day-to-day lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The individual files of 2 service users were examined, both of which were fully completed giving an accurate and sufficiently detailed account of the needs and aspirations of the residents concerned. The assessment process and involvement of the service user inform the care planning process and the plans are regularly reviewed. One resident spoken to confirmed that he is aware of his support plan and risk assessments. Areas of potential risk are addressed within the care planning process and an action plan covering methods to minimise the perceived risks are developed. Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 11 Service users are able to make decisions affecting their day–to-day lives and, where appropriate, have control over their finances. Some service users receive support with aspects of money management and the registered manager stated that although he is not an appointee, two service users have their personal allowance paid into a company bank account, which is then given to the individuals. Records are retained of all incoming and outgoing transactions, which were complete and up to date. Service users confirmed that they receive their entitlements on a weekly basis. The registered manager should investigate alternative methods for the receipt of individual’s finances either through someone independent of the home or directly into a service user’s bank account. Refer to recommendation 1. Mental capacity assessments are in the process of being completed for each service user that will provide information regarding the level of decision making an individual is able to retain control of. This document includes a section on finances amongst other things. Conifers DS0000059959.V367384.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): 12, 13, 15, 16 and 17. Quality in this outcome area is good. Service users have a lifestyle that suits their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents of the home have access to a range of activities and resources for leisure and therapeutic purposes. The majority of service users are now of an older age and choose to spend more of their time relaxing at home. Some residents continue to take an active role in the community attending local drop-in centres, using the library and accessing the shops and facilities of the town. One resident is active in the local church and attends a weekly church group. Some group and individual activities are organised in the home, but the emphasis is on a relaxed, homely environment where people can spend their time as they wish. Residents commented that they are happy and comfortable in the home and that they are free to come and go as they please. One person Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 13 said, “There’s enough to do, I like reading the paper and I go to the shops nearly every day.” It was reported that visitors are welcomed into the home at all reasonable times. No visitors were present at the time of the site visit, but residents confirmed that they can meet and greet visitors without problem. There is sufficient space throughout the home to meet in private. All service users spoken to said that the food in the home is of good quality. There is a good sized kitchen that appeared clean and hygienic. It was well stocked with a range of fresh and non-perishable goods. Menu records are maintained and a choice of food is provided. Residents are consulted about the food they would like to see on the menu. Conifers DS0000059959.V367384.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): 18, 19 and 20. Quality in this outcome area is good. The personal and health care needs of service users are met and medication is managed safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Resident’s support plans provide good detail on the individual preferences of each person that uses the service. Staff respond to the needs and wishes of each resident and were observed to be respectful and possessing a good knowledge of individual preferences. Service users stated that the staff are kind and caring. Most people require only encouragement to meet the personal care and hygiene needs and are fully self-caring. Healthcare records are maintained recording visits to healthcare professionals and the outcome of any consultations and interventions. A number of assessments and records are completed by the home monitoring health care issues. There is evidence that service users access complimentary healthcare services such as opticians and dentists. The registered manager reported that Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 15 the home receives good support from community mental health care services for the residents in the home. All residents are registered with local GPs. Medication is managed safely in the home. A number of minor issues were raised during the course of the visit, which were addressed by the registered manager immediately. However, the home has suitable storage facilities for medication and administration records were clean, maintained and up to date. The registered manager is a Registered Mental Nurse and has a good understanding of medication issues. Staff receive medication training and the registered manager was advised to use his knowledge to develop competency assessments for staff in this area. There is clear evidence that the home has responded to concerns regarding individual medication regimes involving review by the Responsible Medical Officer. Conifers DS0000059959.V367384.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): 22 and 23. Quality in this outcome area is good. Service user’s views are listened to and they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints process in place, a copy of which is given to all prospective service users and is displayed in the home. A record of complaints is maintained. Service users stated that there is an open atmosphere in the home and that the staff and registered manager are approachable. People said that they felt comfortable raising any concerns or complaints and were sure that they would be handled appropriately. 1 complaint had been received directly to the Commission for Social Care Inspection, which was referred to the registered manager. Evidence was available to demonstrate that it had been dealt with appropriately. Policies and procedures are in place relating to issues relating to adult protection and abuse awareness. Staff have attended courses covering Adult Protection and demonstrated a reasonable working knowledge of the issues that it encompasses. 1 Adult Protection alert was raised in relation to the home in August 2007. Following an initial planning meeting the Commission for Social Care Inspection were not notified of any further meetings or investigation. The Chair of the Adult Protection process has not indicated the outcome of the process. The Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 17 registered manager was not aware of any adult protection alerts being raised regarding the service. Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 18 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): 24 and 30. Quality in this outcome area is good. The environment is suitable for the individual and collective needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Conifers is a 10 bedded home for people with mental health problems. It is situated in a residential area on the outskirts of Herne Bay. Parking space is available at the front of the building. The home is in good order and shows evidence of redecoration and refurbishment as required. There is a range of communal space available including a two lounges and a dining area. All of the bedrooms are single rooms and there are sufficient toilets and bathing facilities located throughout the home. The house was clean and hygienic, bright and airy with comfortable furniture and a homely feel. Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 19 There is a garden to the rear of the building with space to sit outside and a lawn and vegetable garden. The laundry facilities are domestic in size and suitable for the needs of the home. It was reported that the home meets the requirements of the fire safety and environmental health departments. Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 20 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): 32, 34 and 35. Quality in this outcome area is good. There is a competent and suitably trained staff team. The home’s recruitment processes are appropriately managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a small staff team in the home. Discussions were held with all those on duty. The care staff appeared knowledgeable about their roles in the home and demonstrated a commitment to the service users. 75 of the staff team have achieved an NVQ level 2 or above and the registered manager stated that it is the expectation that any new staff joining the home will work towards this qualification. 2 staff personnel files were examined both of which contained all required information including proof of identity, CRB/POVA checks and two written references. The registered manager was advised to review the current application form, which requests a limited employment history. Refer to recommendation 2. The training matrix for the home was examined and certificates of training Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 21 seen. These provided evidence that staff attend appropriate training courses. The home uses the Skills for Care Common Induction Standards, a copy of which was seen to be fully completed. Staff receive mandatory training within the first 6 months of employment and other courses are also offered including Medication, Adult protection, Mental Capacity Act and Dementia care amongst others. The registered manager stated that he is dedicated to ensuring staff are well trained and continually looks for new and interesting courses. It was advised that a number of key learning areas could be strengthened further by the introduction of in-house competency assessments. Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 22 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): 37, 39 and 42. Quality in this outcome area is good. The home is well managed in the best interests of the service users. Health and safety issues are managed appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is a Registered Mental Nurse of many years experience who has also completed the required courses to manage a care home. He has over 20 years experience working with people with mental health issues. He is also one of the joint owners of the home. Staff and residents spoke positively about his attitude and capabilities. One staff member said, “this is a nice home to work in, the registered manager is very Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 23 supportive.” One of the residents stated that he has a great deal of respect for the registered manager. The registered manager said that whilst trying to run and manage the home, one of his biggest challenges is getting new referrals for the home and he stated that he is planning to work on marketing strategies in the coming months to generate more interest. Suitable quality assurance measures are in place. Residents and relatives are asked to complete a survey every year and the results of this a put into an annual report format summarising the results. The registered manager is one of the joint owners and works full-time in the home. The second owner also works on a part-time basis, therefore there are on-going opportunities to test the quality of the service and identify areas for improvement or development. All health and safety records and documentation was up to date including service certificates, fire safety logs and accident records. Staff receive appropriate training in safe working practices and there are policies and procedures to underpin this. Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 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 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.V367384.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA7 Good Practice Recommendations The registered manager should investigate alternative methods for the receipt of individual’s finances either through someone independent of the home or directly into a service user’s bank account. To ensure that a full employment and education history is requested on the application form for new staff. 2. YA34 Conifers DS0000059959.V367384.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Conifers DS0000059959.V367384.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!