Inspection on 25/07/06 for Esken House

This inspection was carried out on 25th July 2006.

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 10/09/07

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

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Insight - Eastchurch

Southfields

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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 Ann Block Unannounced Inspection 25th July 2006 04:00 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.V304911.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.V304911.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.V304911.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th December 2005 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 £550 per week. Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection was carried out which included an unannounced site visit to the home on between 10:00 am and 2:00 pm on Tuesday 25 July 2006. The owner, both residents and the two part time staff agreed to speak with the inspector in private and as a group. The inspector was also able to join in the mornings activity by going with the residents, the owner and a member of staff for a drive to the local garden centre for a look round and coffee, followed by lunch back at the house. The owner initially cared for 5 residents through to older age. Currently only two remain in the home, both elderly. The owner is clear there is no wish to accommodate any other residents. Two staff and the owner’s family assist in providing 24 hour care. The family and staff have known the residents for many years and work as a family unit. Elements of many standards are not applicable to this setting. Judgements for this report are based on outcomes for residents assessed through conversation and observation during the inspection, previous knowledge of the service and from the pre inspection questionnaire completed by the owner. The owner said that key records and policies are available. As part of the inspection process survey forms were sent to the residents, relatives and health & social care professionals. All responses indicated complete satisfaction with the service. Comments included: From residents: I enjoy being at Esken House and get on very well with (other resident) and all the staff I have been here 17 years and am very happy and settled at Esken House From care managers: My client is aging and I consider he is very well cared for and managed as part of the homely family set up which is ideal for him and gives him support & purpose. I visited last year for social services & consider for this gentleman the placement is ideal. They have a varied week of activities & trips out – including France. Esme and her team provide an excellent ‘person centred’ service in this small home. Sadly there are not enough homes Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 6 like this where residents’ needs & wishes are foremost. It is always a pleasure to visit and do work with Esme and her team. What the service does well: What has improved since the last inspection? 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. Esken House DS0000023929.V304911.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.V304911.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents chose to move into the home and are very happy there. EVIDENCE: There remain no plans to admit other residents either in the long or short term. Both residents had a two week trial stay to see if they liked the home before they moved in permanently. A statement of purpose and service users guide has been produced. The survey forms recorded that both residents have a contract. Both residents have a good understanding of what they can expect from the service, their rights and responsibilities. They remain very happy in the home and wish to continue living there. Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and care needs are well met to the residents’ choice and satisfaction EVIDENCE: Each resident has a care plan which is reviewed as necessary. The owner, staff and family know the residents very well having worked with them for many years. From observation and conversation staff recognise individual needs and manage this to ensure dignity and privacy are maintained at all times. The residents can largely manage their own personal care needs and just need reminders and gentle guidance. Staff know what assistance is needed and use sensitive prompting where necessary. Health care is very well managed. The owner has a nursing background and upholds the residents’ rights to a good response from health services to any problems that might arise. There is good support from the local GP. Residents are involved in decision making about health care management such Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 10 as diet. Appointments are made with ancillary health services including the dentist and optician. There are minimal medication needs. Medication is properly stored and recorded and given as per prescriber’s directions. The owner has an excellent awareness of the aging process and is able to encourage residents to live an active, healthy life whilst recognising in some areas they are slowing down. Residents are cared for through the later stages of life, the aim is for them to remain in the home as long as possible. Where this is impossible, the owner maintains contact with understanding and support. Residents, relatives and staff are able to pay their last respects and express their feelings around loss. Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14& 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a varied and active life. EVIDENCE: Individual preferences are recognised, whilst the two residents obviously enjoy each other’s company, they may opt to do different things at different times. They prefer their meal times to be around the same time of day, as some routines are comforting and reassuring for them. The residents are consulted with about matters which affect them during their day, with their opinions listened to. They are able to help around the house if they wish. The residents have a full social life. They go out most days and really enjoy their leisure time. Places they enjoy are meals out at the local superstore, a monthly meal out at the local pub, shopping trips, regular shopping and meal out trips to France, lunch at Aylesford Priory, visits to the owner’s family and going for a drive. Trains figure largely in one residents life and opportunities are provided for train journeys such as Eurotunnel. Events which involve the owner’s family include the residents. One resident is booked for a long weekend to Euro Disney later in the year with the owner, the other resident is Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 12 considering whether to join them although previously he has refused to stay away from home overnight. A recent birthday was celebrated with a party and birthday cake. The owner said that she had excellent relationships with a neighbour who she had known for 20 years. The neighbour knew the residents well and would be there for them in any emergency. Visitors, including family, are welcomed to the home. The lunch served during the inspection was meat pie, carrots and potatoes followed by mousse or jelly. Special dietary needs are discussed with health professionals and residents and are catered for, including how the food is served. Both residents obviously enjoyed their lunch which was appetising, fresh and all home made. Regular drinks are made. Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and able to make comment about the service EVIDENCE: There is a written complaint process however neither of the residents would be able to use written information. It is clear that residents would express any dissatisfaction with the service either verbally or by action. Both residents are happy to talk to the owner, her family or staff, in turn they know the residents well enough to know what might upset them and how to act to reduce stress or concerns. Practices and policies protect residents from the risks of abuse or harm. Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have a clean, homely and well maintained environment in which to live. EVIDENCE: The service is a family environment in domestic premises. The chalet bungalow is sited in large gardens with an outlook onto fields and woods. The two residents use the ground floor where they share a bedroom by choice. They have made the bedroom very personal to them with plane and train models, books, photos and pictures. Their effects spread into the lounge where there is a TV and DVD player for their use. They have unrestricted access to all of the ground floor, including the spare bedroom, music room and study. The large dining room is used for meals with a conservatory leading off it. There is a large well fitted kitchen and bathroom with Jacuzzi style bath, over bath shower and toilet. An additional toilet leads from the conservatory. The residents have a small washbasin to use in their bedroom. Aids are in Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 15 place, some remaining from a previous resident, other aids are provided as the need arises. There is a separate utility area. Good standards of cleanliness, both personal and environmental are maintained. Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have staff who are properly recruited who they like and trust EVIDENCE: Two part time staff are employed, both have worked at the home for many years. One works four evenings a week the other works two mornings. There is evidence that, at the time of recruitment, proper recruitment took place. Criminal records bureau certificates have been obtained. Some of the owner’s family also work with residents when the need arises. There are no plans to recruit any additional staff, staffing needs have lessened as the number of residents has reduced. It is evident that the residents like the staff and have good relationship with the owner’s family. One resident got very excited when he was told that one member of staff would be coming in, and even more so when she agreed to come out for coffee with the group. Both staff thought the home was excellent and that the residents couldn’t have anywhere better to live. They both said they had received training when they first started and keep up to date with fire safety training. They recognised that the service was stable with little change and didn’t feel that additional training Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 17 was needed. One family member has NVQ 2, the two part time staff don’t wish to do major training at this stage in their lives. Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well managed and safe service 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 two residents who have the owner’s family and two part time staff to support them. The service is family based and works as a team. The owner said she has relevant policies which staff are aware of. 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 Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 19 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. There was evidence that other services and equipment are properly maintained and that fire safety is promoted. 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.V304911.R01.S.doc Version 5.2 Page 20 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 3 3 3 3 3 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 3 3 3 3 3 3 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 3 3 3 3 3 3 3 Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 21 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. Refer to Standard Good Practice Recommendations Esken House DS0000023929.V304911.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone 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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