Inspection on 02/05/07 for Eva`s Folly

This inspection was carried out on 2nd May 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 found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Eva`s Folly 07/04/09

Eva`s Folly 29/11/05

Eva`s Folly 08/06/05

Eva`s Folly 29/10/04

Eva`s Folly 24/04/04

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

CARE HOME ADULTS 18-65 Eva`s Folly 33 Parrock Road Gravesend Kent DA12 1QE Lead Inspector Jo Griffiths Key Unannounced Inspection 2nd May 2007 1:15 Eva`s Folly DS0000023926.V333350.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 Eva`s Folly DS0000023926.V333350.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. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eva`s Folly Address 33 Parrock Road Gravesend Kent DA12 1QE 01474 320653 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) Ms Rosemary McGinty Ms Kay Reeves Ms Rosemary McGinty Ms Kay Reeves Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: The home provides care and accommodation for 8 people with learning disabilities and some mental health difficulties. The owners (who both manage the home) are registered nurses. They maintain close connections with local organisations concerned with developing services for people with learning disabilities. There are staff on duty 24 hours per day to support service users with daily living tasks and the activities they wish to do. The people living in the home are supported to help with the running of the home and are supported to develop their skills. Each person has their own bedroom. There are comfortable facilities that include a kitchen, dining room, lounge, conservatory, garden and an external office. The home is 10-15 minutes walk from the town centre and there is easy access to public transport. There is a walled garden at the rear. A minibus is available for transport. The base fee for this service is £618.08 per week. Fees are calculated following the assessment of the persons need. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection. The inspector, Jo Griffiths, was at the home between 1.15pm and 5.45pm and spoke with most of the people living at the home. The staff did not know the inspector was visiting so that the home could be seen as it usually is. Some staff were spoken with and some records seen. 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. The summary of this inspection report can be made available in other formats on request. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 6 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 Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective service users are given the information they need about the home, but need to be assured that the information is up to date. Service users have an assessment of their needs. EVIDENCE: The Statement of Purpose contains all the relevant information that people moving to the home would need. The document needs to be reviewed, as the last review date was 2002. The Service User Guide, referred to as Residents handbook, needs some minor review as it still refers to the Registered Homes Act 1984 and this Act was replaced by the Care Standards Act in 2000. The Service User Guide also needs to give accurate contact details for CSCI so that people living at the home know how to contact the Commission should they need to. Each person living at the home has an assessment of their needs. New people moving to the home would have a full assessment to ensure the home could meet their needs. The assessments for the current residents should be kept under review and it is recommended that this be done at least once per year. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, 8 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users have an individual plan that meets their needs, but these need to be kept under review. Service users are supported to make daily decisions and choices but may benefit from further support to plan for their future hopes and dreams. They are involved in the running of the home. Service users are supported to take reasonable risks, but need to have their risk assessments reviewed regularly to ensure their continued safety. EVIDENCE: Each person has a plan of care that includes an assessment of their needs and how those needs will be met. Some care plans identified areas of concern that needed to be addressed. The Manager was able to share the outcome of these issues, but the care plans had not been updated to show that action had been taken. All care plans should be reviewed at least every 6 months or when there is a change in need or the support to be given. The care plans focus on Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 9 supporting individuals with their day to day needs. It may be useful for staff to do some training in Person centred planning to help them support people to express their wishes for their futures and plan for them. Individual preferences and choices are reflected within the care plan. There used to be regular residents meetings in the home but there has not been one since July 2006. One person has recently requested a meeting so it is planned these will be introduced again. It was discussed with the senior support worker how the residents meetings could be used to ensure that people know their rights, what is abuse and who to talk to if they are worried, how to complain, and their responsibilities to respect others living in the home. The people living in the home have a rota that they have agreed between them for helping with cooking and household tasks. There is also a housekeeper in post to carry out most of the cleaning. There are risk assessments in place for each person within their care plan. The Manager must ensure that, where an incident occurs, the risk assessment is updated to take account of this. All risk assessments are due to be reviewed. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported to take part in the activities of their choice and to be a part of their local community. They enjoy a range of leisure activities and are supported to enjoy appropriate relationships. Service users rights are respected and they understand their responsibilities in the home. Service users enjoy a healthy diet with plenty of choice. EVIDENCE: All the people living at the home have busy lives and are consulted on the activities they would like to do. Most people attend day centres or colleges and one person has paid employment one day per week. There is one person that does not go out independently for activities, but is supported by the staff in the home. It is planned that the activities available for this person will be reviewed soon. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 11 As recommended above, Person centred planning training for staff may further assist them to support people in making decisions about the activities they wish to do. The training would also assist staff to support people to plan for their futures and this may include training for employment. Those spoken with said they enjoyed their activities and were looking forward to planning their holiday for this year. It is planned this will be discussed at the residents meeting. Currently everyone in the home goes away on holiday together. It is recommended that consideration be given to offering people the choice of going on holidays in smaller groups. During the evenings people can choose to go out to various social clubs and groups or relax at home. Those who wish to can have a TV in their bedroom. Some people said they enjoy going to the theatre, cinema and bowling and the records in the home showed that these activities were offered regularly. Individuals do not have keys to their bedrooms as they do not wish to lock their rooms. They also do not have keys to the front door. During the inspection those coming home from day activities had to ring on the doorbell to get into their house. It is recommended that those that could use a key be offered one. People living at the home can receive visitors when they wish and have use of the phone to call family and friends. People living at the home are supported by staff to understand and build appropriate relationships. It is recommended, as good practice, that training in sexuality and relationships is provided to staff to help them support individuals in this area of their lives. The home has a very good policy on nutrition and the planned menu offers a balanced and nutritious diet. The menu is used as a guide and is flexible to include choices and people’s lifestyles. People’s likes and dislikes and cultural needs have been considered. Those spoken with said they liked the food and take turns in cooking. This was observed during the inspection. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users’ health needs and personal care needs are met in a way that best suits each individual. They are supported to manage their medication in a safe way. EVIDENCE: The care plans for individuals evidenced that health needs are being met and excellent records of the involvement of health professionals are kept. Individuals needs with regard to their personal care are clear for staff to follow and promote the persons independence as well as meeting their need. Privacy and dignity is evident as being addressed within all the care plans seen. People living at the home said that the staff support them with everything they need. They also said that they can have private time in their rooms and that staff knock before they enter. Each person is supported to manage their medication by trained staff. The storage of medication is secure and only trained staff have access. One medication was found to have just expired and staff arranged for this to be Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 13 replaced immediately. The medication policy requires a review as it currently refers to guidance from KCC dated 1999 and this has since been updated. The Manager is advised to refer to good practice guidance with regard to medication, which can be found on the CSCI website. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users’ views are listened to but they would benefit from more support to understand how to make a complaint. Service users are protected from abuse. EVIDENCE: There is a complaints procedure that supports people living at the home, or their relatives, to raise any concerns. The complaints procedure is currently in written form and it may be of benefit to the residents of the home if it is translated into symbols or pictures. It is recommended that the residents meetings that are being reintroduced be used to discuss what a complaint is and how to make a complaint so that people understand this. There have been no complaints received be the home since the last inspection. Staff have been trained in safeguarding vulnerable adults and there is a clear policy on reporting suspected abuse for staff to follow. There is also a whistleblowing policy to allow staff to report concerns anonymously if they feel they need to. Again, it would benefit the people living at the home to regularly revisit the topic of abuse in a supportive way during residents meetings or on an individual basis. This is to ensure they understand what is considered abuse, what their rights are and how to report it. It is recommended that the policy be produced in pictures or a format that would help people to understand it. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 26, 27, 28 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users live in a clean, safe and comfortable home that meets their needs. They have access to sufficient private and shared space and bathroom facilities. EVIDENCE: Each person has their own bedroom that they have been supported to furnish and decorate to their own taste. There are enough bathrooms and toilets to meet the needs of all the people living at the home. Since the last inspection a new kitchen has been fitted and the lounge has been decorated. The decorator was beginning work on the dining room and it is planned that the bathrooms will be refurbished this year. All areas of the home are kept clean and hygienic. People living at the home can spend time in their rooms if they wish or can relax in the lounge, dining room or conservatory. The kitchen is fully accessible to everyone to make drinks and snacks if they wish to. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35 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 trained and competent staff and are protected by safe recruitment procedures for new staff. Service users would further benefit from more staff undertaking the NVQ award in care to support good practice. EVIDENCE: The staff team at the home have been working with the people living there for many years and there is a low turnover of staff. 3 of the 8 care staff are currently working toward the NVQ award. It is recommended that at least 50 of the care staff achieve the NVQ award as good practice. The staff records show that training has been provided to staff in all the areas they need to support people safely. Updates have been provided as needed, although it is recommended that staff be provided with an update in Safe Moving and Handling. Staff spoken with said they enjoyed training and felt they were supported and valued by their employers. Further staff training courses that may benefit the people living at the home have been mentioned Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 17 throughout this report. This includes training in Sexuality and Person centred planning. Records evidenced that any new staff are recruited following robust policies to protect the people using the service. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 40, 41 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users live in a home that is well managed and is run in their best interests. Service users health and welfare are promoted and protected. EVIDENCE: The 2 owners jointly Manager the home and are both registered nurses. They continue to update their knowledge through training and conferences and networking with social services and other providers. The managers are at the home most days and review the records in the home as part of regular quality monitoring. Policies and procedures have been recently reviewed although it was noted that the Statement of Purpose. Service User Guide and medication policy require some minor amendments. Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 19 The Manager are advised that they must carry out an annual quality review of the home and provide a copy of the results to CSCI and the people living at the home. This should include gathering the views of the people living at the home. The people living at the home will benefit from the residents meetings that are to be reinstated. The health and welfare of the staff and the people living at the home is assessed and protected. Safety checks are made on equipment in the home and servicing of the fire system is carried out at least annually. Where incidents are reported using the incident/accident forms the Managers must ensure that any action taken to prevent a recurrence is recorded. Staff keep accurate and detailed records for each person. An entry on the persons care plan report is not made daily, but made when there is a change or something to report. Whilst this is acceptable it has resulted in only negative reports being made, for example when someone is unwell, and staff should also be encouraged to report positive activities and things the person has achieved or enjoyed doing. This gives a fuller picture of the person’s lifestyle and helps staff when it comes to reviewing care plans. Eva`s Folly DS0000023926.V333350.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 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 2 2 2 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 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 2 X 3 X 2 3 3 2 X Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 21 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 4 and 5 Requirement The statement of purpose and service user guide must be reviewed and amended to reflect the Care Standards Act. Service users assessment of needs must be kept under review. Service users care plans must be kept up to date to reflect changes in need or action taken to address needs. Service users risk assessments must be kept under review to ensure that risks continue to be minimised. Risk assessments must be reviewed following any accident or incidents relevant to the risk assessment. The medication policy must be reviewed and updated to reflect current good practice guidance. The registered person must ensure that a quality review of the home is carried out at regular intervals and a copy of the report is published for CSCI and service users. The review should include the views of the service users. The registered person must DS0000023926.V333350.R01.S.doc Timescale for action 01/07/07 2 3 YA2 YA6 14 15(2)(b) 01/07/07 15/06/07 4 YA9 13(4)(b) 15/06/07 5 6 YA20 YA39 13(2) 24 15/06/07 01/08/07 7 YA42 13(4)c) 15/06/07 Page 22 Eva`s Folly Version 5.2 ensure that the action taken to reduce the risk of an accident or incident occurring again is recorded on the incident report as part of the audit trail. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA7 YA8 Good Practice Recommendations It is recommended that staff undertake training in Person Centred Planning to assist them in supporting service users to make decisions about their lives and futures. It is recommended that the residents meetings be reintroduced as planned. These meetings could include discussion with residents about making complaints and adult protection. It is recommended that service users be offered the opportunity to go on holiday in smaller groups. It is recommended that staff be provided with training in sexuality to help them to support service users with their relationships and with building new relationships. It is recommended that service users be offered a key to their front door. It is recommended that the complaints procedure be produced inn a format that is easy for service users to understand and that the topic is regularly discussed with them. It is recommended that the Manager and staff work with service users to ensure they understand their rights with regard to protection from abuse and how to report it. It is recommended that at least 50 of the staff team hold a NVQ award. It is recommended that updates in moving and handling training be provided for staff. It is recommended that positive events and activities that service users undertake be recorded in the daily notes. 3 4 5 6 YA14 YA15 YA16 YA22 7 8 9 10 YA23 YA32 YA35 YA41 Eva`s Folly DS0000023926.V333350.R01.S.doc Version 5.2 Page 23 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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