Inspection on 29/07/08 for Culby House

This inspection was carried out on 29th 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

Culby House 18/07/07

Culby House 19/09/06

Culby House 05/09/05

Culby House 31/05/05

Culby House 21/01/05

Culby House 24/06/04

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 Culby House Culby House 32 Warwick Road Cliftonville Margate Kent CT9 2JY Lead Inspector Joseph Harris Unannounced Inspection 29th July 2008 11:00 Culby House DS0000023181.V369131.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 Culby House DS0000023181.V369131.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. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Culby House Address 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) Culby House 32 Warwick Road Cliftonville Margate Kent CT9 2JY 01843 298887 Mrs Jean Kelly Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2007 Brief Description of the Service: Culby House is a small family style home occupying a terraced property with three bedrooms for residents use on the first and second floors. Residents have their own lounge/diner overlooking a small, enclosed patio area to the back. The registered provider/manager, Mrs Kelly, lives at the home with her children and has a separate lounge, dining room and bedroom accommodation for family use only. The residents have one toilet and a bathroom for their use and there are separate facilities for the family members. The home is situated in a residential area of Cliftonville, close to shops and other communal facilities. Parking is on-street. Mrs Kelly is the main carer but there is a volunteer, who regularly helps out. Fees are £320.63 to £320.98. For information regarding fees please contact the provider. Culby House DS0000023181.V369131.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 29th July 2008. The site visit commenced at approximately 11am and concluded at 3pm, lasting for around 4 hours. During the course of the visit a tour of the premises was undertaken and discussions were held with the manager 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 manager has addressed requirements and recommendations made at the last inspection. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 6 A review of care planning and risk assessment has ensured that perceived risks relating to each resident are considered and addressed in a positive, enabling manner. Issues relating to the administration of medication have also been suitably addressed. Necessary health and safety checks have been carried out by suitably qualified practitioners. The manager has also provided appropriate training courses for the voluntary workers who help out in the home. 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. Culby House DS0000023181.V369131.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 Culby House DS0000023181.V369131.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): 2. Quality in this outcome area is good. The needs of prospective service users are assessed prior to moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the current residents have lived in the home for 5 years or more and there is no expectation that this situation will change in the foreseeable future. However, the manager stated that in the past the home has received referrals readily when a vacancy has occurred through care managers or the Community Mental Health Team. The home requests referral information including the most recent Care Programme Approach (CPA) care plans and risk assessments and background history. It is reported that the prospective resident is central to the referral process, being offered time to spend in the home at a pace that suits the individual. 2 individual service user files were examined that both contained CPA documentation and other assessment information. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 9 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. The needs and risks relating to each service user are planned for and 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: 2 individual service user files were examined, both of which contained well developed plans of care addressing all the key areas of need for the individuals in question. Residents have some involvement in the care planning process. The AQAA confirms that residents are consulted about their care plans. At the current time the manager reviews and rewrites each care plan on a monthly basis. Some suggestions were made to ensure the plans are regularly reviewed, but in a less time-intensive manner. This was taken on board by the manager. The plans themselves provide sufficient detail regarding each resident, their needs, goals and aspirations. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 10 Risk assessments are completed for each resident with the main body of this information included in the plans of care. The manager uses her knowledge of each resident, CPA documents and other available information to inform the risk management process. The aim of the home is to enable residents to live as independently as possible and, to this end, the assessments are positive and support responsible risk taking. Discussions were held with two of the service users who both confirmed that the home is relaxed and that they are free to choose how to spend their time each day. One resident said, “I can pretty much do what I like within reason.” Service users are supported to be as independent as possible in relation to their finances. One resident manages his money with complete independence. The two others are given their full weekly personal allowance every week. Records are retained of these transactions. The manager assists financially with the purchase of some items such as clothes and toiletries when required. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 11 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 and recreational activities that suit their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are supported to pursue the activities of their choice at home and in the local community. The emphasis is on providing a home first and foremost, but all of the residents are very independent and are able to access community resources of their own accord. The manager provides support where required and cited an example where one resident felt anxious about attending a new group, so was accompanied on the first few occasions. Some of the service users regularly attend a number of activities including a church social group, the library and local college courses. The AQAA submitted by the home confirms that residents are involved in a range of local activities. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 12 Service users confirmed that they are able to receive visitors as they wish and at all reasonable times. One person said, “This is a very sociable house, there’s always people popping in.” Residents are able to choose how they spend their time with respect to when they get up and go to bed, what to wear and daily routines. There is enough space throughout the home to enable people spend time in company or alone. Residents spoken to said that the food in the home is of good quality. Choices are available at each mealtime and service users are involved in the planning of menus and in the preparation of meals if they wish to do so. Menu records are retained and the stocks of food included good quality produce including fresh fruit and vegetables. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 13 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. Personal support is offered in a way that service users prefer. Healthcare needs are met and medication is safely managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the residents currently living in the home are self-caring and independent with regard to personal support. The manager stated that she sometimes needs to remind and encourage people to attend to their personal hygiene and care needs, but that this tends to be the limit of her input. Support plans identify the preferences, likes and dislikes of each individual. Service users said that they are treated respectfully and as part of the household. The health care needs of residents are met. All people are registered with local GPs and the manager stated that she receives excellent support from Community Mental Health Teams and care managers. Complimentary healthcare needs are met with regular appointments with the Chiropodist, Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 14 dentist and opticians. Records are retained of healthcare issues and any changes noted as a result of consultations. Medication systems, records and storage facilities were examined. The manager has recently introduced a Blister pack system of medication dispensation, which she says has simplified processes. Medication administration records were examined and were accurate and up to date. The manager has completed medication training and demonstrated a good knowledge of issues relating to medication that may impact on service users. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 15 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 users 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: The home has complaints policy in place, which is included in the Service user’s guide. The manager and residents confirmed that most issues are dealt with on an informal basis, but the formal complaints process is available if required. No complaints have been received by the home or by the Commission for Social Care Inspection since the last inspection process. Adult Protection policies and procedures are in place and staff have received training relating to Safeguarding Vulnerable Adults. The manager was advised to organise training in the Mental Capacity Act as this is particularly pertinent to the service user group. Refer to recommendation 1. No Adult Protection alerts have been raised in relation to the home since the last inspection process. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 16 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 needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Culby House is run as a family home and combines communal areas with dedicated space for the service users and the manager and direct family. The communal space and resident areas were inspected during the tour of the premises. The service provides comfortable, clean and well decorated accommodation throughout. There is a range of communal space including a television lounge and a dining/sitting room area with an integrated enclosed patio. The kitchen is large with a breakfast bar and contains equipment suitable for the needs of the home. All bedrooms are single occupancy and have been designed Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 17 according to individual taste and choice. There are sufficient toilet and bathing facilities in the house. There is an attractive garden to the rear of the home and available parking at the front of the building. The home is close to local shops and resources and approximately ½ mile from the centre of Margate with good public transport links. The home was clean and hygienic. Laundry facilities are domestic in scale and suitable for the needs of the service. It was reported that the home meets the requirements of the fire safety and environmental health departments. Universal precautions are in place to control infection. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 18 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, 33, 34 and 35. Quality in this outcome area is good. Service users are appropriately supported by competent and trained staff. Suitable recruitment processes are in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The house combines both a family home and a residence for service users. As such there is a mix of people involved in the day-to-day lives of the service users. The main support is provided by the manager who lives in the house, but additional support is provided by some of the manager’s family. The home also uses voluntary support from a number of family friends who mainly provide cover when the manager is away. The manager recognises that due to the nature of the home and staffing residents must have a reasonable high level of independence and self-caring skills. The manager ensures that everyone working in the home has completed mandatory training and staff have also attended a course covering Adult Protection. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 19 Sufficient recruitment checks have been completed for those working in the home. Key information is on file for the manager, voluntary workers and family members. CRB checks have been completed, however the manager was advised to contact the Criminal Records Bureau for guidance on the issues that affect the home. Refer to recommendation 2. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 20 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 run, in the best interests of the service users. Provisions to health and safety issues are in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has owned and run the home for over 20 years and has a breadth of experience in the field. She is in the process of completing her National Vocational Qualification level 4 in care and management issues. She has continued to update her knowledge through training courses and liaison with mental health practitioners. She is day-to-day charge of the home and lives in the premises providing the vast majority of support. The manager has Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 21 responded positively to the advice, requirements and recommendations of regulatory authorities and keeps the Commission for Social Care Inspection informed of any relevant information. Suitable quality assurance measures are in place, most of which is monitored on a daily basis through discussion with service users and checks on the environment. Residents and relatives are asked to complete an annual survey providing feedback about the quality of the service. All health and safety documentation examined was up to date including service certificates and fire safety checks. Safe working practices are adhered to and staff receive training appropriate to their roles. Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X 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 3 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 Culby House DS0000023181.V369131.R01.S.doc Version 5.2 Page 23 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. 2. Refer to Standard YA23 YA34 Good Practice Recommendations To arrange training in issues relating to the mental Capacity Act 2005. To obtain further guidance regarding CRB requirements for family members resident in the home. 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