Inspection on 10/09/07 for Esken House

This inspection was carried out on 10th September 2007.

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

Esken House 25/07/06

Esken House 06/12/05

Esken House 21/06/05

Esken House 18/02/05

Esken House 19/07/04

Esken House 23/03/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

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 HOMES FOR OLDER PEOPLE Esken House 69 Charlesford Avenue Kingswood Maidstone Kent ME17 3PH Lead Inspector Mrs Sue Gaskell Key Unannounced Inspection 10th September 2007 10:00 X10015.doc Version 1.40 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 Esken House DS0000023929.V348571.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 Older People. 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. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Esken House Address 69 Charlesford Avenue Kingswood Maidstone Kent ME17 3PH 01622 843786 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) Mrs Esme Davis Mrs Esme Davis Care Home 2 Category(ies) of Learning disability over 65 years of age (2) registration, with number of places Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th July 2006 Brief Description of the Service: Esken House is a detached chalet bungalow providing accommodation for two male residents who have a learning disability. The accommodation is on two floors, with the residents having their living space on the ground floor. The owner lives on the premises, the first floor is for her use only. The home is situated in a quiet residential area approximately 5 miles from Maidstone. The ground floor accommodation includes a shared bedroom with nurse call facility, lounge, separate dining room, study, music room, guest room, conservatory, kitchen and utility room. The home has its own transport and provides car parking facilities to the front of the property. There is a large garden with swimming pool to the rear of the house. The home is staffed on a 24 hour basis and is described as a ‘home for life’ for the two residents living there. The owner has provided care to the current residents for many years, there are no plans to admit any other residents. Current fees are £600 per week. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 10th September 2007 between 10.0 and 13.00. There was 1 person living at the home. The owner said that she does not intend to fill the remaining vacancy. I spoke to the resident and to the one member of staff. I toured the building and looked at all communal areas. The resident showed me his bedroom. The inspection process also consisted of information collected before and during the visit to the home, and feedback from relatives after the site visit finished. Other information seen included risk assessments, care plans, and medication records. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. One recommendation has been made to improve the risk assessments. What the service does well: What has improved since the last inspection? Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 6 The owner ensures that she makes any changes to care and support for the two residents as they arise. Ongoing maintenance and repairs to the property are made as in any domestic premises. 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. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. The statement of purpose, service user guide and individual statement of terms and conditions, says what service will be offered. Prospective residents can be confident that their needs will be assessed and met. This judgement has been made using available evidence including a visit to this service. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 9 EVIDENCE: There remain no plans to admit other residents either in the long or short term. The current resident had a two week trial stay to see if he liked the home before he moved in permanently. A statement of purpose and service users guide has been produced and the residents have been issued with a contact. The resident has a good understanding of what he can expect from the service, and his rights and responsibilities. He remains very happy in the home and wishes to continue living there. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is good. The care plan is basic but describes the resident’s needs. The resident’s healthcare needs are monitored regularly and all his needs are met. The resident is protected by the home’s policies and procedures for dealing with his medication. This judgement has been made using available evidence including a visit to this service. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 11 EVIDENCE: The resident’s care plan was examined in detail. Although the information is basic, it includes an assessment of his current needs, his likes and dislikes, and guidelines on how the home will assist him in achieving any goals. The owner monitors the resident’s individual needs and activities and helps him understand, and contribute as much as possible to the way his care is managed. There is regular input from a variety of healthcare professionals and there is evidence to show that the resident is referred for specialist help if he has other health care needs. The home keeps good records of GP’s and district nurses’ visits etc, together with any subsequent advice. The owner and one member of staff showed a high level of awareness of the resident’s needs and referred to a variety of issues, such as the importance of ensuring that residents’ needs are treated with sensitivity and that the care is consistent. Two relatives of the resident said that they are satisfied with the care provided and that the home has managed the resident’s needs appropriately. There is generally only the owner, or one other member of staff on shift. The owner, staff and family know the resident very well having worked with him for many years. The resident can largely manage his own personal care needs and just needs reminders and gentle guidance. Staff know what assistance is needed and use sensitive prompting where necessary. The care plans, daily records and risk assessments indicate that this is appropriate to the current resident’s needs. There are no issues or problems relating to confidentiality and confidential records are stored in an appropriate place. The home has sound medication procedures. The owner confirmed that only trained staff may administer medication. Although no formal risk assessment has taken place, the owner said that it would not be safe for the resident to store and/or administer his own medication. Medication is stored securely and appropriately. The medication records are clear and current and there is a system for the receipt and disposal of medication. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. Daily life meets the resident’s lifestyle preferences and expectations. The resident has regular contact with his family and friends. The resident receive a nourishing and balanced diet. This judgement has been made using available evidence including a visit to this service. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 13 EVIDENCE: The resident enjoys a wide range of social activities and has a full social life. He goes out most days shopping or to places of interest. He told me that he will be going for a day trip to France and then to Spain for a holiday. The resident is treated as a member of the family and he is included in events involving the owner’s family. He recently had a birthday and celebrated with a party and birthday cake. The care plans contain a list of the resident’s needs, likes and dislikes and preferences. Although there is reference to risk assessment in the care plans, the risk assessment would benefit from more detail on the actual risks and how they will be managed. There is evidence in the residents’ daily records to show that the resident’s family and other visitors are encouraged and welcomed. Although the resident does not currently have an independent financial appointee, he has an individual bank account which is regularly audited, with appropriate receipts and records kept. Two signatures are required for monies taken out. The resident helps choose the menus, and enjoys going shopping. The store cupboard contained a wide range of good quality food including fresh fruit and vegetables. Nutritional assessments are carried out and the resident is assisted with any dietary needs. The resident does not have any specific ethnic, religious or cultural needs. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. Residents are able to say what they think about the service. Residents are protected from abuse by the home’s practices and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The one resident has lived in the home for many years and was seen to be relaxed and comfortable talking with the owner and member of staff. Two of his relatives said that he has thrived since moving to the home and can speak up for himself more. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 15 Although the home has complaints forms, these have not yet been produced in a pictorial format or any other format which may be more understandable for the resident. The home has appropriate procedures in place and the owner said that staff have in the past received training on safeguarding adults. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. The home provides a homely, comfortable and safe environment. This judgement has been made using available evidence including a visit to this service. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 17 EVIDENCE: The one resident who lives in the home showed me his bedroom and lounge. He said that he likes his bedroom. The home is run as a family style unit in domestic premises. All bedrooms and living areas are comfortably furnished and decorated to a good standard. All areas are clean and well maintained. All main rooms for residents are on the ground floor and are wheelchair accessible. There is a well-maintained garden and with garden furniture which is used by the resident. Maintenance certificates are current and there are no outstanding health and safety requirements. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. Staffing levels are appropriate to the needs of the resident. Staff show a good knowledge of good care practices and are well supported.. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Now that there is only one resident in the home, and there is no intention to take further residents, staffing is maintained by the owner, her family Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 19 members and one part time member of staff. All of these people have been subject to CRB checks. The member of staff said that she has received training in the past in core subjects such as fire safety, moving and handling and first aid. She said that she is well supported and enjoys working in the home. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. The resident benefits from a well managed service. Although the resident is supported in taking risks in the daily and social activities that form part of an independent lifestyle, the risk assessments would benefit from more detail. This judgement has been made using available evidence including a visit to this service. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 21 EVIDENCE: The owner is a registered nurse and has many years experience in running a service for older people with learning difficulties. The service has reduced to provide care for a maximum of two residents. The home is staffed by the owner’s family and one part time staff. The service is family based and works as a team. The owner said she has all the necessary policies and procedures. The member of staff I spoke to showed a good awareness of these policies. Most day to day issues are discussed ‘over the dining table’ in an informal manner rather than as recorded meetings. Due to the small and close knit team, this is an effective way of communicating necessary information and for the residents to put their point of view. Whilst there is no formal quality assurance system, the views of placing agencies, health professionals and family are taken into account in assessing the effectiveness of the service. Residents’ financial affairs are properly managed in conjunction with the resident, family and advocates. Essential records are held and stored securely. A daily record for each resident is maintained, significant incidents and events are fully documented. Fire and ‘nurse call’ systems are regularly serviced and the staff showed a good awareness of fire safety. The power supply and electrical appliances and checked regularly. Good health and safety practices are followed including food hygiene and systems to reduce the risks of cross infection. The owner notifies incidents which affect the wellbeing of service users to the correct authorities. Esken House DS0000023929.V348571.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 23 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. 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 Refer to Standard OP38 Good Practice Recommendations Extend risk assessments to include more detail regarding the potential risks, together with guidelines on how to minimise risks. Esken House DS0000023929.V348571.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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