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Inspection on 08/08/06 for Corner House Nursing Home

Also see our care home review for Corner House Nursing Home for more information

This inspection was carried out on 8th August 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a core staff team who continue to be committed to the support and care of the service users. Service users seen were clean and well dressed and staff demonstrated a good understanding of their needs.

What has improved since the last inspection?

The manager has made available a copy of the National minimum standards for staff to familiarise themselves with. A "Makaton" word for the week is placed on the notice board for staff to learn and use to develop service user communication abilities. The manager is continuing to review the format of support plans.

What the care home could do better:

The Statement of purpose and service user guides need to be reviewed and updated to reflect the actual facilities and age ranges within the home. The manager has attempted to introduce more stimulating activities for service users and this is an area that requires further development. The limited communal space does not facilitate areas for small groups or quiet areas for individuals. Training for the staff team in supporting communication and meaningful activities would be of benefit in meeting the complex needs of service users.

CARE HOME ADULTS 18-65 Corner House Nursing Home 116 Cheriton Road Folkestone Kent CT19 5HQ Lead Inspector Paul Stibbons Unannounced Inspection 8th August 2006 08:10 Corner House Nursing Home DS0000026088.V311433.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 Corner House Nursing Home DS0000026088.V311433.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. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Corner House Nursing Home Address 116 Cheriton Road Folkestone Kent CT19 5HQ 01303 258892 01303 258922 cornerhouse@counticare.co.uk 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) Mr William Puxley Care Home 19 Category(ies) of Learning disability (19), Physical disability (19) registration, with number of places Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 18 of the 19 nursing beds are also registered for the admission of Residential Clients Residential Clients who are physically disabled must also have a learning disability 13th October 2005 Date of last inspection Brief Description of the Service: Corner House provides care and support to adults with physical and learning disabilities, some of whom also have some health conditions and sensory impairment. It is a large detached home situated in a residential area of Folkestone. The building is in keeping with the local area and is close to the town centre, the leisure centre and parks. Accommodation is on 3 floors, all of which can be reached by a passenger lift. There are 9 single bedrooms, 5 shared bedrooms and 2 with en-suite bathrooms. A conservatory has been built at the front of the building to provide more indoor space for service users. The home has no garden. There is spacious parking and 2 gateways. Corner House is part of a group of homes owned by Counticare that also provide a day service in Folkestone called the Martello. Fees for this home range between £1060 and £1560 per week with additional charges for hairdressing, personal requisites. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted on the 8th August 2006 commencing at 0810 hours and concluding at 1600 hours. A completed preinspection questionnaire and four survey responses were received by the CSCI prior to the inspection date. A tour of the building was carried out and various records and documents were examined. Service users were unable to communicate with the inspector and therefore some judgements are through observation. The inspector was able to speak with staff on duty and at length with the home manager. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 6 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 Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 7 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The individual aspirations and needs of service users are assessed with input from other relevant healthcare professionals. EVIDENCE: The Statement of Purpose needs reviewing to accurately describe the age range of people for whom the service is intended, information received indicates that 5 service users are outside the conditions of registration. A variation to conditions of registration must be applied for to the CSCI immediately. Individual care plans viewed contain comprehensive assessments of the needs of individuals including input from NHS registered nurses using recognised assessment tools. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 8 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): 6,7,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assisted to make decisions about their lives and are supported to take risks as part of an independent lifestyle. Their right to confidentiality is clearly upheld. EVIDENCE: Service user plans are in the process of being updated to reflect current and relevant information. There is still some work to do in this area but progress made thus far is acknowledged. Care plans examined evidenced that risk assessments had been carried out and appropriate controls put in place to protect service users from harm. Communication with service users is very limited, but observation of staff and service user interaction clearly demonstrated a good understanding of needs and wishes. Sensitive information was securely stored in the manager’s office and nurses station. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 9 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): 12,13,15,16,17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There has been progress in creating opportunities for service users to engage in appropriate activities and access the local community, however this area still requires further development. They are offered a healthy diet according to their wishes. EVIDENCE: The majority of service users are wheelchair users with little or no verbal communication. The manager has trained in the use of “Makaton” and has introduced a “word of the week” system for staff and service users to learn, this word is displayed on the notice board. On questioning not all staff were sure what the current word was. Observation of interactions demonstrated a staff team that is committed to the well-being of the service users. Two staff were seen to be working under the directions of a qualified Physiotherapist who was present at the time of the Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 10 visit. Other staff were observed taking some service users out in their wheelchairs. The manager stated that in-house activities include massage, woodwork, art, pottery and manicures. Service users have the opportunity to go to the theatre, disco, bingo and have recently been to a “Showtime” at the Leas Cliff Hall and are going to a sports day at Richardson Court. Discussions with the Homes manager reveal there are plans to change the conservatory into a quiet area/sensory room for the service users benefit. However, it is difficult to see how this can be achieved without impinging on the privacy of service users whose rooms adjoin the conservatory. The home has no outside garden area for service users to access in good weather and they have to use the garden of another nearby home owned by the company. The homes manager stated that there are plans to redesign the home and this was confirmed later by one of the company directors. Mid-day lunch was observed and meals appeared to be appetising and well presented. Staff were observed assisting individuals to eat in a respectful and dignified manner. Discussions with the cook and staff demonstrated their awareness of the likes and dislikes of service users with communication difficulties. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 11 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive the support they require and are protected by the homes policies and procedures for dealing with medication. EVIDENCE: Medication storage and recording procedures were examined and observation of medication being administered. Only qualified nurses administer medication and records examined were accurately completed. Medication was kept in a locked drugs cabinet and procedures were compliant with Royal Pharmaceutical Society of Great Britain guidelines. Care plans viewed evidenced referrals to other Health care professionals where required and observations demonstrated an understanding by staff of the personal support service users required. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 12 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are unable to communicate their views verbally or in writing and are dependent on others to interpret their wishes, staff observed appeared able to do this satisfactorily. Service users are protected by the homes policies and procedures around Adult protection issues. EVIDENCE: Observation of the interaction between staff and service users demonstrated a good understanding of service users wishes. The manager has implemented a system where staff members learn a new Makaton sign each week to encourage communication with service users. Surveys completed by relatives state they are consulted by the home to determine service users wishes. The manager stated that future training planned includes “Intensive interaction” and “Life planning”. All staff have received training around adult protection issues. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 13 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): 24,26,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a clean, hygienic and safe environment. Outdoor space and shared communal space within the home is very limited. EVIDENCE: Areas of the home have been decorated creating a homely and bright environment. Bedrooms viewed reflected the interests of individuals by displaying their personal possessions. Specialist equipment is provided where required and the manager stated this is under the input and advice from the physiotherapist. The home was clean and tidy and free of any offensive odours. The conservatory is still not in use by service users and areas for them to relax in smaller groups are very limited. Other than the dining area there is only one other small lounge. Discussions with the manager reveal plans to provide outdoor areas, weather permitting, and the company has plans for internal alterations. The requirement remains to make provision for additional communal space for service users. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 14 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): 32,34,35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users benefit from good basic care, given by staff who are competent in meeting their health and personal care needs. Staff should be given the opportunity to develop their skills in communication, social interaction and occupation with service users. Service users are protected by the homes recruitment policy and practices. EVIDENCE: There are currently six full-time staff vacancies for the home and the manager states that interviews are underway. The manager confirmed that no potential employee starts work at the home until two satisfactory references, POVA First check and CRB have been received. The manager stated that there is always six members of staff in addition to a registered nurse on duty. Mandatory training is provided for staff but there appears to be little progress in meeting the target of 50 of staff with an NVQ2 qualification. In addition staff should be given the opportunity to develop their skills in communication, social interaction and occupation with service users. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 15 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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having an experienced manager in place and their health, safety and welfare is promoted and protected. The manager has identified areas in which the home needs to develop and has made some progress in these areas. EVIDENCE: The manager in place is a qualified nurse for people with learning disabilities and is currently studying towards the NVQ4 in Management award. The manager has put in a lot of effort to improving standards within the home and recognises the need to further develop areas identified in this report. An application for registration as the homes manager must be submitted to the CSCI. Staff members spoken with valued the leadership and management approach of the home. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 16 Various records examined evidenced that health and safety checks are made and a tour of the building showed no obvious hazards. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 17 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 2 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 2 25 X 26 3 27 X 28 2 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 2 13 2 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 Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4(1-3) 5(1-3) 6 Requirement a) The statement of purpose needs to be a working and reliable document for providing information on what the people moving into the home and their relatives/advocates/represen tatives can expect. This needs to be kept under review. b) b) Complete service user guide and a modified version suitable for service users in the home with communication difficulties. Make provision for additional communal space for service users. If the conservatory is going to provide this, then it needs to be made safe, secure and comfortable. Action plan to be supplied by timescale. Timescale for action 10/11/06 2. YA24 YA28 23(2)(p) 10/11/06 Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 19 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. 2. 3. 4. Refer to Standard YA12 YA13 YA24 YA32 YA33 YA35 Good Practice Recommendations To provide opportunities to develop social skills and leisure activities. To consider how the home can be organised into clusters of up to ten people. To be implemented by 2007. To continue to work towards 50 of the staff team achieving NVQ level 2 or above. For nursing staff to access specialised training to update knowledge in supporting people with learning disabilities and guide staff with current good practice. To develop the staff training range to incorporate supporting communication, socialisation and increase meaningful occupation. Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 20 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 Corner House Nursing Home DS0000026088.V311433.R01.S.doc Version 5.2 Page 21 - 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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