Inspection on 16/12/08 for Ellens Court

This inspection was carried out on 16th December 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

Ellens Court 11/03/08

Ellens Court 17/09/07

Ellens Court 06/10/06

Ellens Court 22/11/05

Ellens Court 07/06/05

Ellens Court 15/03/05

Ellens Court 09/02/05

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ellens Court Lady Margaret Manor Doddington Sittingbourne Kent ME9 0NT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joseph Harris     Date: 1 6 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Ellens Court Lady Margaret Manor Doddington Sittingbourne Kent ME9 0NT 01795886220 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Lynn Brooks Type of registration: Number of places registered: Mrs Lynn Brooks care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 9 The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability - LD Date of last inspection Brief description of the care home Ellens Court is a 9 bedded home providing 24 hour care and support to adults who have a learning disability. The home is owned and managed by Sally (Lynn) Brooks. A team of care staff and ancillary staff support her. The home is located in a rural setting approximately one and a half miles outside the village of Doddington. The property is detached and the accommodation is located on 2 floors. The upper floor consists of 5 single bedrooms and a W.C. The ground floor has four single bedrooms, a large comfortable lounge, a separate smaller lounge, a shower room, a bathroom, further W.Cs, a kitchen, laundry and a dining room. There are several outbuildings including a Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 9 Brief description of the care home games room, a workshop, and a kitchenette that is used to promote independent living skills for the service users. The property has extensive grounds that are attractively laid out and well maintained. The statement of purpose and service user guide is kept in the office. All service users have an individual copy of the service user guide. Weekly fees range from £722.75 to £1336.00. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection process culminated in site visit to the service on the 16th December 2008. The visit commenced at 9.30am and lasted for approximately 6.5 hours. During the course of the inspection discussions were held with service users, staff and the manager. A tour of the premises was undertaken and some service users allowed the inspector to see their bedrooms. A range of documentation was examined including service user files, medication records, menu records, health and safety documentation and other information relating to the running of the home. The home returned their Annual Quality Assurance Assessment (AQAA) when we asked for it and it was completed in good detail providing all the information that we asked Care Homes for Adults (18-65 years) Page 6 of 27 for. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users needs are assessed prior to admission. Evidence: No new service users have been admitted to the home for over 3 years, therefore it was not possible to inspect this standard fully. The home does have a pre-admission assessment process in place. Information is initially received from care managers such as care plans, risk assessments and joint assessments. The manager stated that when a referral is received she visits the person in their current accommodation. The individual is then invited to visit the home and trial stays are arranged depending on individual needs and wishes. The home completes a pre-admission assessment, which provides the basis of initial care plans. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs and choices of service users are planned for and monitored. Evidence: Two service user plans were examined and, in both cases, the needs and preferences of each individual had been clearly planned for. The plans are positive in enabling and promoting independence and largely provide good guidance to ensure that staff can consistent provide the support service users require. In one case it was noted that guidance and action plans for working with a residents aggressive outbursts and other issues had involved liaison with a clinical psychologist. This guidance was not fully reflected in the care plan and it was advised that these issues should be included. Refer to recommendation 1. All care plans show evidence of regular review and the involvement of service users. Service users stated that they are able to make decisions affecting their day-to-day lives and there was further evidence of this in the support plans. The home does not take a financial appointee role for any service users and, where required, this role is Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: taken on by someone independent of the home. The home has a well established risk management process in place that focuses on positive outcome for service users. The risk assessments promote positive risk taking and provide good guidance to ensure perceived risks are minimised. The assessments are regularly reviewed. The manager stated that there are plans to introduce an improved risk management process that are linked more closely to the care plans. This was discussed with the manager and copies of the proposed format examined. This new process should improve the flow of information. Refer to recommendation 2. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have a lifestyle that suits their needs. Evidence: The home offers a good range of recreational and occupational activities for service users. These include activities such as arts and crafts, quizzes, music therapy, golf, swimming and outside entertainers. Residents confirmed that they go out in one of the homes two vehicles regularly. Two service users help out at a local farm working with animals and other residents attend a service called Skillnet that helps them with activities of daily living. Other people do woodwork and handicrafts at a service called Ecoshed and are able to sell the goods that they make. A small theatre group visit periodically to stage performances and have recently put on a pantomime in the homes activity room. The activity room also holds parties and has snooker and air hockey tables. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: The home organises regular outing and there is an annual holiday for residents. One person said, Theres lots to do. I really enjoyed the panto and someone else added, I like to go shopping and play golf. Im getting good at golf now. Service users are encouraged and supported to maintain good links with families and friends and there are open visiting times. The home held a Christmas party and it was reported that lots of family members attended. Some residents are spending Christmas with their families. The home keeps in contact with residents next of kin informing them of any pertinent issues. The home has three cooks who cover the 7 days a week. Menus are planned in conjunction with residents and likes and dislikes are catered for. There are choices available at each mealtime. The home buys in good quality, locally sourced foods where possible and the cook stated that all the equipment in the kitchen is in good working order. The food stores were well stocked and menu records maintained. All of the service users were very positive about the quality of food. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of service users are met. Evidence: The home has clear guidance in place relating to the personal care needs of the service users. Staff were observed to interact positively and respectfully with service users. Residents confirmed that they receive the support that they require and when they require it also saying that all the staff are helpful and considerate. The home maintains clear healthcare records showing evidence of input from a range of healthcare professionals. All service users are registered with local GPs and have care managers attached to Community Learning Disability Teams. Healthcare records show that any health issues are appropriately monitored and referred and the outcomes of any consultations are recorded. Residents visit complimentary healthcare specialists such as chiropodists and dentists regularly. The manager reported that support from care managers varies. Some service users have regular care reviews, but other care managers are less diligent in this respect. The manager was advised to formally request reviews of care where this had not occurred for over a year. Refer to recommendation 3. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: The home has good processes in place relating to medication. Policies and procedures are followed and administration records are up to date and well maintained. Storage facilities are suitable for the needs of the home and records are retained of all received, returned and destroyed medications. No controlled drugs are in use. Staff receive medication training appropriate to their roles. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users views are listened to and acted upon and they are protected from forms of abuse. Evidence: The home has a complaints procedure in place and copies of this are displayed in the home and contained in the service users guide. Service users stated that they feel comfortable raising concerns with staff and feel confident that they will be dealt with. There was evidence that complaints received by service users are addressed and resolved proportionately. Issues of complaint are recorded and any outcomes documented. No formal complaints have been received in connection with the service since the last inspection. Policies and procedures are in place relating to adult protection and abuse awareness issues. Staff demonstrated a good awareness of the rights of service users and their responsibilities to report any possible abusive practices. Staff have received training in Adult Protection and the Mental Capacity Act 2005. The manager also showed a good awareness of legislation such as the Deprivation of Liberty Safeguards that are due to be implemented. No Safeguarding Vulnerable Adult alerts have been received in connection with the service since the last inspection. Care Homes for Adults (18-65 years) Page 17 of 27 Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is suitable for the needs of the service users. Evidence: Ellens Court is located in a rural area near to the small village of Doddington and approximately 7 miles from the towns of Sittingbourne and Faversham. The house is surrounded by extensive grounds and has a large, accessible garden. The premises are comfortable and homely and all the service users spoken to said that they enjoy living in the home. There are a number of communal areas including a lounge, dining room, games room and office area that is shared by staff and residents. All of the bedrooms are single rooms and have been personalised according to taste. The house appeared to e in a good state of repair and well decorated throughout. The home employs a maintenance man full-time who addresses any on-going maintenance issues. There are sufficient toilets and bathrooms throughout the building suitable for the needs of the residents. The home also benefits from a large, well appointed kitchen and recently achieved the clean food award from the Environmental Health Department. There is a separate laundry area that has sufficient equipment in good working order. Hazardous substances are stored safely and procedures are in place to minimise the spread of infection. Care Homes for Adults (18-65 years) Page 19 of 27 Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a competent and well-trained staff team employed in sufficient numbers. Recruitment practices protect the welfare of residents. Evidence: Over 50 percent of the staff team have achieved an NVQ level 2 or above and a number have now commenced the level 3 qualification. In discussion all of the staff demonstrated a good awareness of the needs and preferences of the residents and showed competent practice in their roles. The staffing levels in the home are sufficient to comfortably meet the needs and wishes of the residents. There are at least 2-3 care staff on duty at all times excluding the manager who tends to work from 7am to 6pm throughout the week. This is supplemented by cooks, a maintenance man, domestics and a part-time administrator. The home has 1 waking night staff. All of the service users commented that the staff are attentive to their needs and there are always enough people available to support them in and out of the home. The staff training matrix was examined and cross-checked against certificates on two staff files. The majority of mandatory training has been completed and updated for staff, although a number of gaps in this were noted. The manager stated that a training programme has been developed for 2009 ensuring that all training needs are Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: met. Refer to recommendation 4. Additional service specific courses have been provided including the Mental Capacity Act 2005, epilepsy and autism amongst other topics. The home has achieved the Investors in People Award. 2 staff personnel files were examined both containing all required information including two written references, proof of CRB and identity, training certificates and application forms. The manager was advised to obtain a POVAfirst check for staff employed in the future to enable people to commence supervised work whilst waiting for the CRB check. Refer to recommendation 5. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run in the best interests of the service users. The health and safety of service users is promoted. Evidence: The manager has been overall control of the home for a number of years and has obtained all the required qualifications. Staff and service users spoke in positive terms about her qualities as a manager and colleague. Suitable quality assurance processes are in place. The home employs an external Quality Assurance assessor despite the manager owning the service and being in day to day control of the home. Annual satisfaction surveys are sent out to residents relatives and professionals. Regular resident meetings are held and the input of service users is encouraged in the daily running of the home. All health and safety documentation examined was up to date and in place, this included service safety certificates such as gas and electrical wiring. Fire safety and accident records were complete. Environmental risk assessments have been completed and are regularly reviewed. Policies and procedures underpin safe working practices. It Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: was reported that the home meets the requirements of the fire and environmental health departments and associated legislation. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 6 9 19 To ensure that all plans of care provide clear guidance for staff to meet assessed needs. To continue to develop updated risk management processes. The home should contact care managers of service users who have not had a formal care review for over one year requesting that this is carried out. To obtain a POVAfirst check for newly employed staff. To continue to update the mandatory training needs of staff. 4 5 34 35 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!