Inspection on 02/09/05 for Dartford Road (16-18)

This inspection was carried out on 2nd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Dartford Road (16-18) 25/05/05

Dartford Road (16-18) 13/12/04

Dartford Road (16-18) 09/06/04

Dartford Road (16-18) 23/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Dartford Road (16-18) 16-18 Dartford Road Dartford Kent DA5 2AZ Lead Inspector Elizabeth Brunton Unannounced 2 September 2005 11.30 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 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 Stationary 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. Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Dartford Road (16 -18) Address 16 - 18 Dartford Road Bexley Kent DA5 2AZ 01322 524 610 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) MCCH Society Limited Mrs Pauline Brooks Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25 May 2005 Brief Description of the Service: 16-18 Dartford Road is a care home which provides care for up to five adults with learning disabilities. The home has been open since September 1999 and is operated by the Maidstone Community Care Housing Ltd (MCCH). The home is two semi-detached houses, which have been converted into one house. There is a large lounge/dining room, kitchen, smaller lounge and a conservatory , which is used as an activities room. The home has five single bedrooms, one on the ground floor and four on the first floor. There are also three bathrooms, a laundry room, office and a small additional room on the first floor, which is used by one of the service users for activities. There is an enclosed garden to the rear of the property, which is wheelchair accessible. The home is situated on a busy road, close to shops and buses. Access to the home is via a sloping path or driveway. On the day of inspection, there were five service users living in the home and no vacancies. Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 11.30am. The inspector was in the home for five and a half hours. Two service users were spoken to and two additional service users were seen. It was not generally possible to find out the views of service users, because of communication issues. The senior support worker and other care staff on duty during the day were spoken to. The manager was not seen as she was off work due to sickness. The communal rooms, garden and service users’ bedrooms were seen. Records were looked at, together with some service users’ individual case files. What the service does well: What has improved since the last inspection? What they could do better: As at the previous inspection, service users still did not have proper contracts for their residence in the home, setting out exactly what services would be provided. Some parts of the building and garden also still needed attention. With additional staffing hours, service users could be supported in developing new leisure time activities. The home had been well managed but it must be visited each month by MCCH, as required by the regulations. Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 6 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. Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 & 5 Assessment information was on file but contracts for service users were still needed, in order to give service users full information about the services provided in the home. EVIDENCE: There was much information about resident service users on their files and staff spoken to clearly knew them well. No new service users had come to live in the home for several years. Comprehensive contracts for service users were still needed. This has been outstanding for three years. Service users and their relatives or representatives needed clear information about the terms and conditions of residence in the home. (see requirement 1) Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9 Service users had taken part in regular planning meetings, where goals had been set. Service users had made decisions and choices about their lives and were supported by staff in developing their activities and independence. EVIDENCE: Individual planning meetings had been regularly held with service users and their relatives, where varied and achievable goals had been set. One service users individual planning meeting had been delayed due to issues at his day centre but regular person centred planning meetings had been held with him. Service users were encouraged to make choices and to take part in the running of the home, as much as they were able. Service users chose what they wanted for lunch on the day of inspection and helped to prepare it. One service user chose to go to the library and a member of staff agreed to accompany her. Staff said that service users decided whether they wanted to attend day centres, join in outings and other activities. Staff had supported service users in developing their interests and activities and in being as independent as possible. One service user went to the local shop on her own. A good understanding of this service user and her moods Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 10 and reactions enabled staff to ensure her safet, while encouraging her to maintain her independence. Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12 & 15 Service users were supported in developing their communication skills, pursuing activities and in maintaining contact with their families. EVIDENCE: Staff had continued to work with service users on developing communication in the home. They had supported one service user in learning to speak a number of additional words. The possibility of referring this service user for professional speech therapy should be considered. A number of service users regularly attended local religious services. Most service users attended day centres and one young man went to college. Service users pursued a variety of activities at home and went bowling, shopping, out for meals, to the library and local places of interest and on occasional day trips. Two of the staff are to be commended for having recently accompanied two service users on a five day holiday. Staff had also worked hard at trying to support one service user in developing his interests and activities. Additional dedicated social pursuits staffing hours would enable more time to be spent on this. Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 12 Most service users had contact with relatives and staff encouraged and supported them in this. One service user was away on holiday with his family. His parents rang for advice, which was given in a supportive way by the senior support worker. Staff had responded sensitively to one service user’s attachment to a particular member of staff. Staff are to be commended for assisting this service user in compiling a photo album of happy times spent with relatives and friends, which the service user clearly took pride in. Service users were seen to make relaxed and friendly contact with each other. (see recommendations 1 & 2) Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Healthcare and personal needs were well met. Medication was safely stored and had been properly administered. EVIDENCE: Staff were seen to support service users with their personal care discreetly and with respect for their privacy and dignity. Service users were well dressed. One service user had bought new summer clothes and was pleased with her appearance. Following discussion at a recent staff meeting, the senior support worker had drawn up easy-to-follow and comprehensive staff guidelines for supporting one of the service users, in order to avoid challenging behaviour. Information about service user’s health care needs was seen on file and service users had been well supported by staff in attending to these. The senior support worker is to be commended for the written guidance provided for staff on one service user’s medical condition and its effects. Medication had recently been audited by the MCCH clinical nurse specialist. As part of this, the competence of each staff member to administer medication had been reviewed and re-affirmed by the senior support worker. Medication was safely stored. A sample check of medication and administration records was made and this was satisfactory. The administration of homely remedies Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 14 had been recorded and the homely remedies in use had been approved by the GP in January 2005. Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 A complaints procedure was in place and service users were protected from harm and abuse. EVIDENCE: There had been no complaints since the last inspection. Some service users living in this home had limited communication and it could be difficult for them to complain, if they wished to. There had been no reported adult protection concerns since the last inspection. Staff spoken to were aware of safe practice and committed to the protection of service users. The senior support worker was in close touch with service users, staff and with day-to-day events in the home. Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 The home was sufficiently spacious, comfortable and generally well maintained. However, some work was needed on the house and garden. EVIDENCE: The home was generally well decorated and furnished. There was ample communal space for five service users and the second lounge and conservatory/activity room was available for activities or quiet time. Service users and staff were delighted with the home’s pair of lovebirds, who had successfully reared five young. Bedrooms were highly personalised. Four were spacious and the occupant of the smaller fifth bedroom had an additional small room for activities. Re-decoration of the hall, landing, bathroom and a bedroom on one side of the property had been awaiting an asbestos check. This had now been carried out but the result was not yet known. The stair carpet on the other side of the house had worn in places and could be a hazard to service users and staff. The front of the house still needed painting and, as at the previous inspection, a new dining table and chairs was needed to improve the appearance of the lounge/dining room and the comfort of service users. Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 17 Some work was needed on both the front and rear gardens, to make them more attractive for service users. Extension of the existing patio would make the rear garden more accessible. Tree stumps with jagged tops required attention, as these could be a hazard to service users. The senior support worker had tried to organize removal of these but, so far, without success. The home was generally clean, apart from the bathrooms and some radiators. The manager later informed the CSCI that the whole building had been thoroughly cleaned. Shift planners had also been amended, so as to prompt staff to clean all parts of the home regularly. (see requirements 2, 3, 4 & 5 and recommendations 3, 4, 5 & 6) Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 & 34 The home was adequately staffed by an able and well supported staff group. One member of staff’s personnel file had been mislaid by MCCH. EVIDENCE: Staff on duty were competent and committed to meeting the needs of service users. Service users spoken to said that staff were kind and helpful. There was a happy atmosphere in the home and morale amongst the staff group seemed to be good. Recent rotas showed that there were always two staff on duty. The need for additional staffing hours to support service users in undertaking activities has already been mentioned. There were two vacant posts. A member of staff had been appointed to one of these but it had not been possible to recruit to the second vacancy. This post was to be readvertised. Regular bank staff were used and agency staff only occasionally. Staff recruitment records kept in the home were checked at the previous inspection in May 2005. Of the two staff for whom there were no records, one had left and the other had given notice. It is a matter of concern that the latter member of staff had worked for MCCH for many years and his personnel file was said to have been mislaid. This meant that no information concerning his recruitment, training and past work performance had been made available to the senior support worker, who was currently acting as manager. Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 19 Two staff were to commence NVQ training in October 2005. The senior support worker is to be commended for providing regular 1:1 supervision to staff, during the manager’s absence. She should be provided with supervision training. A staff meeting had been held during the previous month, at which the needs of individual service users had been fully discussed. The previous staff meeting had been held in January 2005. Staff meetings should be held more regularly. (see requirement 6 and recommendations 7 & 8) Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 & 42 The home had been very well managed during the manager’s absence. The health and safety of service users had been protected, though some additional measures were required. EVIDENCE: The manager had been on sick leave since early April 2005. During that time, the home had been very well run by the senior support worker, who was now officially acting-up into the manager’s position. The senior support worker was committed to developing the service in order to better meet the needs of service users. Staff commented on how effective and accessible she had been as acting manager. The senior support worker had been well supported by the staff team and, more recently, by MCCH. Evidence that the views of service users underpin all self-monitoring, review and development by the home, was not available and MCCH are asked to provide this. There was no record of monthly provider visits having been Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 21 made to the home since April 2005, though a visit was said to have been made earlier in August. The building appeared to be safe and no hazards or risks to the safety of service users were identified, apart from the worn stair carpet already mentioned and the two electric sockets in one of the hallways, mentioned in the previous inspection report. These were unsafe to use and consequently taped over but a more permanent solution was still needed. The senior support worker had been trying to find out from MCCH when the work required/recommended by the last inspection of the gas installation was to be done but without success. Records showed that fire equipment had been regularly tested and checked and fire drills regularly held. Attention needed to jagged tree stumps in the rear garden has already been mentioned. (see requirements 7, 8 & 9 and recommendation 9) Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 1 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 3 3 x x 3 x x Standard No 31 32 33 34 35 36 Score x 3 3 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dartford Road (16-18) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 4 x 2 x x 2 x G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 23 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 5 Regulation 5(3) Requirement Each service user must be provided with a copy of their terms and conditions of residence in the home, which includes all the matters listed under this standard. (This has been outstanding since April 2002) The worn stair carpet must be replaced, as this could place service users and staff at risk. Outstanding internal redecoration work must be carried out, once the result of the recent asbestos check is known and provided this is negative. (Redecoration work has been outstanding for more than a year.) The garden must be maintained in a safe condition for service users. Jagged tree stumps must be removed. (This has been outstanding since May 2005) All parts of the home must be kept clean. The manager later informed the CSCI that the whole building had been thoroughly cleaned. The required staff recruitment records must be kept in the Timescale for action 1 November 2005 2. 3. 24 24 13(4) 23(2) 1 November 2005 1 November 2005 4. 24 13(4) 1 November 2005 1 October 2005 5. 30 23(2) 6. 34 17(2) 1 October 2005 Page 24 Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 7. 8. 39 42 26 13(4) 9. 42 13(4) home for all staff (This has been outstanding since May 2005) Monthly recorded visits must be made to the home by the provider. The faulty electrical socket in one of the hallways must be attended to. (This has been outstanding since May 2005) The outstanding work on the gas installation(s) must be carried out. (This has been outstanding since May 2005) 1 October 2005 1 November 2005 1 November 2005 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. 5. 6. 7. 8. 9. Refer to Standard 11 12 24 24 24 24 33 36 39 Good Practice Recommendations The possibility of speech therapy should be considered for one service user. Additional staffing hours should be provided to enable service users to participate in additional leisure time activities. The front garden should be attended to. The patio area in the rear garden should be extended. The front of the house should be painted. The dining table and chairs should be replaced. Staff meetings should be regularly held. The senior support worker should be provided with training in staff supervision. MCCH are asked to provide CSCI with information about the self-monitoring, review and proposed development of the home and the ways in which service users views underpin this. Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection River House 1 Maidstone Road Sidcup Kent, DA14 5RH 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 Dartford Road (16-18) G51 G01 S38185 Dartford Road V225774 02.09.05 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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