Inspection on 20/06/06 for Ebbsfleet House

This inspection was carried out on 20th June 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ebbsfleet House 30/06/08

Ebbsfleet House 24/01/06

Ebbsfleet House 07/07/05

Ebbsfleet House 19/01/05

Ebbsfleet House 14/04/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Ebbsfleet House Ebbsfleet House Tubbs Lane Ramsgate Kent CT12 5DH Lead Inspector Brenda Pears Key Unannounced Inspection 19 September 2006 10:00 th Ebbsfleet House DS0000037202.V299260.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 Ebbsfleet House DS0000037202.V299260.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. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ebbsfleet House Address Ebbsfleet House Tubbs Lane Ramsgate Kent CT12 5DH 01843 825226 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) High Quality Lifestyles Limited Stephen Paul Wood Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th July 2005 Brief Description of the Service: Ebbsfleet House provides support and accommodation for five service users with learning difficulties. The home is a detached property in a large expanse of grounds and has been adapted to meet the needs of the current service users. There is parking to the front of the building and a large enclosed garden to the rear. The main body of the home accommodates four service users with a self-contained area known as the cottage accommodating the fifth person. Although the home is not in a central residential area, transport is available and outings and shopping trips are regularly undertaken following completion of risk assessments. The fees for support from the home are set during the assessment period and are very individual to the needs of the service user, depending on the level of support required and the staffing numbers provided. Fees can therefore range from low to higher thousands of pounds following the appropriate assessments. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken with a focus on the well being, safety and quality of life for service users living in the home. The methods of inspecting the home included speaking to service users and members of staff. A tour of the building and observations of both staff and service users at this time are reflected in this report and evidence outcomes. Questionnaires were also sent to families and health care professionals. The responses received through questionnaires provide valuable feedback that helped with the completion of this inspection. At the time of this report being completed, questionnaires had been received from two care managers and one GP. What the service does well: What has improved since the last inspection? An external area has been cleared and building will soon start to provide another independent unit on site. A training programme has been developed for all staff and refresher dates are recorded to maintain appropriate knowledge. Some areas have been redecorated and refurbished and additional work is planned for the home. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 6 Service user files seen at this inspection now contain appropriate and clear records. 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. Ebbsfleet House DS0000037202.V299260.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 Ebbsfleet House DS0000037202.V299260.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs and aspirations of any new service user are assessed before a move into the home and contracts are issued, ensuring full awareness of individual needs. EVIDENCE: Care plans state what support is required for service users to achieve goals. These may be small achievements but all are recognised as attainments. Plans state what words or actions assist each person and charts show achievements and activities during each set period. This ensures that each service user makes advances, both large and small, in their own time and with appropriate assistance. Ebbsfleet House DS0000037202.V299260.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans reflect changing needs of service users and service users make decisions about daily life, supporting independence and appropriate care. Service users are supported to make decisions and be involved in the running of the home. Reasonable risks are taken where this is seen as appropriate to fully develop life experiences in a safe way. EVIDENCE: Care plans seen at this time were organised and contained clear records in all sections. Files contained full recordings of support areas that included risk assessments, communication methods, interaction, activities and support levels. Each service user decides their daily routines and activities are only undertaken at the request of each individual. This recorded on daily care Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 10 plans, ensuring each person is supported to make decisions and has control over their own life. Changing routines and likes and dislikes are also recorded on care plans. This ensures that the correct support is given and that care plans reflect the needs of each individual at any time. Service users are supported to take reasonable risks to allow them to undertake the activities they wish to. All risk assessments are kept under review and activities are risk assessed to ensure that the risks undertaken are manageable and appropriate. This maintains the safety of each service user while supporting development and creating opportunities to grow as individuals. Ebbsfleet House DS0000037202.V299260.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 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 good. This judgement has been made using available evidence including a visit to this service. Choices are encouraged and supported to ensure service users engage in appropriate leisure activities in the local community. Service users enjoy a balanced and healthy diet with snacks available at any time. EVIDENCE: All activities are decided through consultation with the individual and clearly set out in their person centred plan and supported by appropriate staffing levels. Notice boards clearly show what activities are to be undertaken during the day and the names of allocated staff are also on display. This clearly identifies chosen activities and who takes responsibility for organising these activities. Some activities regularly undertaken include horse riding, swimming, bowling, cinema and walks on the beach. One person who is unable to actually ride a Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 12 horse enjoys waling beside the horse and rider at the stables. Personal care plans contain clear records of all activities undertaken. Two service users have enjoyed a holiday in Bognor and others have also enjoyed daily outings on public transport. All relationships that are important to service users are encouraged and constant contact supported. Events in the home are undertaken with involvement and support from friends and family wherever possible. When at home service users can watch television in the lounge or their bedroom if they choose. They all enjoy a variety of activities and service users can enjoy using the large garden at the rear of the house in the summer. There is a wide variety of food available, and meal preparation is undertaken with assistance. Each person has whatever they wish for their meals and snacks are available as needed. All food eaten is recorded on personal care plans and health is monitored. Menus for the day were on display at this time. Ebbsfleet House DS0000037202.V299260.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 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. Staff do ensure healthcare needs are met, consider the dignity of service users and treat individuals with respect. Medication is stored and handled in line with requirements. EVIDENCE: Health is monitored through observation regarding food that is eaten, weight charts and behaviour patterns. There is a regular review of medication and adjustments are made as recommended. There are also charts maintained for all observations of the individual including food eaten, outings undertaken or refused. All these observations are regularly reviewed to support and inform individual assessments and to identify specific triggers to behaviours. Healthcare professionals and additional professionals had no areas of concern and stated that staff do work in partnership and ensure the privacy and dignity of service users. All questionnaires received from professionals were positive and contained no negative replies. One reply explained how the home finds ‘a positive approach to difficult behaviours’. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 14 Medication is appropriately stored and was found to be orderly and records were clearly completed and up to date. Full information about medication is also contained on records. Ebbsfleet House DS0000037202.V299260.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 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. There is a complaints procedure in place but this must contain fuller information including timescales. Routines and practices in the home do support and protect service users. EVIDENCE: There is a complaints procedure in place but this currently has no stated timescales or when letters will be sent out or what a complainant should expect from the home. This is needed to make sure complaints are dealt with in an acceptable time, are confirmed in writing and do not drag on too long. There is also a policy on whistle-blowing and this does contain timescales, but attention must be paid to ensure policies are fully dated to identify when they were issued and also when reviews are needed. There have been no complaints received to date and staff work closely with family and visitors to ensure continued contact. This enables any issues or worries to be dealt with directly and quickly. Where service users require support regarding certain behaviours, clear guidance is contained in the service user plan. Incidents are recorded and monitored but are not always appropriately reported to the Commission for Social Care Inspection. This was discussed with the manager at this time who will ensure this is now undertaken. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 16 Money is securely stored and two signatures are recorded on financial records with all receipts being retained on file. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 17 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, 25, 27, 30 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 a relaxed and clean home but some areas are in need of upgrading. EVIDENCE: One service user in the home at this time was told about the inspection and asked for permission to see his room. Some areas in the home have been refurbished and decorated and one new toilet has been installed since the last inspection. The entrance hall is to be redecorated and new cupboards are to be installed in this area and also in the kitchen. Each room reflects the individual preferences of service users and one person now has their own television and can now enjoy these in their own room. A new rug and armchairs have also been purchased since the last inspection, as these are now appropriate for the service users concerned. Some personal rooms do need continued maintenance checks to be undertaken to ensure the appropriate standards are achieved in all areas. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 18 A self contained flat attached to the home has ample space and the kitchen has been made safe. However, the bathroom in this area is used quite often on a regular basis but is currently in a very poor condition. The bath needs replacing to provide a suitable and appropriate bathing area. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 19 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, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by appropriate recruitment procedures with sufficient numbers of trained and qualified staff to meet their needs. EVIDENCE: Rotas evidenced that staff numbers are appropriate to the needs of the service users. The rota shift on the day of this inspection showed four staff on shift during the morning, one person due on mid morning, with four staff on duty during the afternoon plus one newly appointed person who was shadowing. There is a formal induction programme in place that includes two days at head office for induction and followed by at least five days of shadowing staff and getting to know service users. During this time new staff read guidelines, care plans and any required training is identified. Discussions with staff confirmed this is fully undertaken. All recruitment checks are undertaken centrally by the organisation and files seen at this time contained all appropriate paperwork and references to safeguard service users. There is a full training programme in place with identified refresher dates and some staff are currently attending a course on Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 20 Positive Behaviour Support. Other training booked includes First Aid and Manual Handling. Files evidence that staff have regular supervision and time is allocated on the rota to ensure this time is taken while service users are appropriately supported. Staff meetings are also regularly undertaken and staff expressed a good understanding of service user needs and routines. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 21 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. The staff and routines in the home protect and promote the safety and well being of service users. EVIDENCE: The current manager of the home has many years of experience both with the organisation and of previously managing Ebbsfleet House. It was evident through discussions with staff at this time that they are well supported and involved in the running of the home. Service users are supported by staff that are trained and competent to do their jobs. There are clear policies and procedures, risk assessments and safety checks within the home. Records showed the fire system is tested regularly and all equipment used in the home had been serviced. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 22 Quality assurance is currently not formally carried out but the home works closely with other agencies, healthcare professionals and families. This continued contact supports immediate feedback and discussion. However, a formal quality assurance procedure, that is used on a regular basis, must be developed. All areas in the home are made safe for service users, locks are in place for areas containing dangerous products, cooking areas are guarded and fire exits are appropriately signed. Items around the home are protected and made safe for all service users. Regular and appropriate servicing is undertaking including appliance testing, electrical and emergency lighting as well as fire extinguishers. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 23 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 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 2 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 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 1 X 2 3 x Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 YA22 Regulation 5, 12 Requirement The complaints policy must contain timescales and what action a person can expect from the home. A formal quality assurance programme must be developed to record the opinions of those who have contact with/visit the home. A copy of all incident reports must be forwarded to the Commission for Social Care Inspection. Bathrooms in all areas must be in a good condition and be replaced where necessary to provide suitable and appropriate bathing areas for service users. Timescale for action 03/11/06 2 YA39 17, 24 31/12/06 3 YA41 24, 37 30/09/06 4 YA27 12, 23 31/12/06 Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 25 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 YA13 Good Practice Recommendations That there is an ongoing maintenance programme in place to maintain an acceptable environment in all areas of the home. Ebbsfleet House DS0000037202.V299260.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Kent and Medway Area Office The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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. 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