Inspection on 08/06/05 for Eva`s Folly

This inspection was carried out on 8th June 2005.

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

Eva`s Folly 07/04/09

Eva`s Folly 02/05/07

Eva`s Folly 29/11/05

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 Evas Folly 33 Parrock Road Gravesend Kent DA12 1QE Lead Inspector Eamonn Kelly Unannounced 08 June 2005 15:30 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 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 Stationary 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. Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Evas Folly Address 33 Parrock Road Gravesend Kent DA12 1QE 01474 320653 01474 350584 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Rosemary McGinty & Kay Reeves Rosemary McGinty & Kay Reeves CRH Care Home 8 Category(ies) of Learning Disability (8) registration, with number of places Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29 October 2004 Brief Description of the Service: Eva’s Folly provides care and accommodation for 8 people with learning and physical disabilities and some mental health difficulties. Each service user has his/her own bedroom. There are safe and comfortable facilities that include a kitchen, dining room, lounge, conservatory and garden. There is a garage at the rear over which a new office has just been completed. The owners (who both manage the home) are registered nurses (RGN and RM) [Rosemary McGinty’s first nursing qualification was “Registered Nurse for the Learning Disabled”]: they maintain close connections with relevant organisations concerned with developing services for people with learning and physical disabilities and mental health difficulties. There is a “staff-mix” of owner/managers, housekeeper and support workers. Twenty-four hour care and supervision is provided. The home is 10-15 minutes walk from the town centre and there is easy access to public transport. There is a private garden at the rear. A minibus is available for transport of service users. Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit concentrated on meeting service users, members of staff and owners. Some service users were also met at day care locations in Dartford and Gravesend. Some of the home’s records were viewed and parts of the premises were visited. What the service does well: What has improved since the last inspection? What they could do better: The home has continued to build on its approach to providing suitable care and accommodation for its service users. Ongoing reflection is needed to continue to meet the needs of people as normal and unexpected ageing problems occur. Good progress has been made in maintaining a safe and comfortable environment for residents. Staff training to equip members of staff with Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 6 detailed knowledge of working with people with learning disabilities has been a priority. Against a backdrop of such progress and innovation, no particular areas were identified on this occasion where improvements were recommended. 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. Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 5 The statements made about the home’s services and facilities in pre-admission documents (ie statement of purpose/service user’s guide) are being met in practice. Service users benefit from continuing reviews of their aspirations and care needs. EVIDENCE: Suitable written information is available to potential service users and their families/friends/advocates to help them assess whether the home can meet their needs. Information gained at the early stage of assessment forms the basis for service users’ subsequent individual care plan. Some service users have lived at the home since 1991 and the others have lived there for around 6 years. Admission of new service users is therefore a relatively rare occurrence. There was evidence from the profiles of each service user discussed and from meeting them at the home and at external locations that members of staff have a detailed knowledge of their personal, physical and aspirational needs and that this knowledge forms the basis of care plan provision and reviews of care. Each service user receives a personal contract that includes a statement of the rights and responsibilities of both parties (i.e. the service user and the home). Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 & 10. Service users have opportunities for personal goals to be identified and they receive assistance in making decisions about their lives. EVIDENCE: Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 10 Individual care plans outline the assessed needs of each service user and how each aspect of these needs is being met. The process has now been transferred to computer and members of staff have easy access to each record. The care plan records seen contained an accurate account of care needs, risk assessments and outcomes of care required. It was clear from meeting service users that they each have enough assistance so that they could contribute directly towards development of their lifestyles. There is an emphasis on helping residents in making decisions about their lives. The home acts as appointee to a number of service users: there are strict controls in place in these circumstances. During the inspection visit, the types of routines followed by service users were observed. The person whose turn it was that day (the arrangement for which had been previously agreed at a staff/service user meeting) to help prepare the evening meal carried out several domestic tasks. Examples of written risk assessments related to premises, individuals and procedures. [An example was a service user with diabetes who is helped by a member of staff to take blood tests and perform an insulin injection]. All potential risks in relation to premises, procedures and individuals are assessed (as far as is practicable) at appropriate intervals with outcomes recorded. Records were securely stored and service users/specific advocates have access to their own records (although they do not often exercise this right). Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11-17. Links with the community are good. Service users receive excellent support and assistance in availing of opportunities for personal development and taking part in activities and leisure pursuits. EVIDENCE: Service users are helped by members of staff to develop appropriate confidence (examples included service users being able to express themselves, being involved in various aspects of domestic activities depending on individual capabilities, talking to visitors with confidence and discussing their planned activities). Service users have access to employment and education opportunities. They live as part of the local community, whether with the support of staff or in the temporary care of local day centre staff. They have access to transport; the home’s minibus, staff vehicles, day centre minibus’s, public transport to enable them to carry out the activities agreed as part of their care plans. Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 12 Service users have their own audio/visual equipment in their bedrooms (plus access to communal facilities). There are annual holidays in the UK and abroad. Each day and evening there are planned and spontaneous activities for each service user. [On the evening of the inspection visit, there were 2 visits to take place: four service users were attending a nightclub (08.00-midnight, via the home’s minibus) and four were attending a local Mencap club]. Visitors may call at any reasonable time and sometimes by prior agreement because service users are often out. On some days of the week, service users are generally at home with members of staff and there may be spontaneous decisions to visit other venues. A support worker explained how service users are helped to maintain relationships with family members and others including how service users are assisted with specific problems if necessary regarding relationships and with gaining confidence in their skills and abilities. Rules on smoking and use of alcohol are stated in the personal contract. There are rules (the implementation of which are discussed and agreed at staff/service user meetings) on how service users carry out household tasks. Service users have varying levels of autonomy depending on their individual abilities the examples of care plan records seen indicated that actions which could be regarded as restrictions are explained (and updated as necessary). There was evidence indicating how service users are assisted and encouraged to be as independent as their capabilities allow. Members of staff assess their potential capabilities and programmes are in place to improve/encourage their capabilities. Service users assist staff with the planning of meals and with the purchasing of food. On a rota basis, service users help to prepare the evening meal. This is to avoid confusion and excessive risk in the kitchen. It was clear that members of staff know each service users preference regarding food and this information is recorded in individual plans, examples were seen in the computerised records. The provision of evening dinner was witnessed during this inspection visit. Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Service users benefit from very good access to personal and healthcare support. Personal care is provided in a way which enhances service user’s privacy and dignity and promotes independence. EVIDENCE: There are male and female members of staff to provide personal support to male and female service users. Personal support is provided to the level required by each service user. Additional support is provided from time to time when service user’s health required, an example was that a hoist was purchased but is no longer used because the service user’s health has improved. Service users have good access to medical facilities. Generally service users visit medical staff for planned consultations. There were some complex medical conditions where the owners succeeded in obtaining specialist medical intervention on behalf of service users. Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 14 The administration of all medication is recorded on MAR (medication administration record) sheets. All medication coming into and leaving the home is recorded. Appropriate support is given to each resident eg one service user is helped to take his own blood test and administer insulin by injection. There was evidence that procedural guidelines requiring members of staff to provide flexible personal support and care to maximise service users’ privacy, dignity, independence and control over their lives are effectively implemented. These ensure that the healthcare needs of service users are assessed and recognised and that procedures are in place to address them. The home has a good track record in assisting service users with problems associated with aging and illness. Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home has adequate measures in place to protect service users. EVIDENCE: Reports are made to the CSCI of all notifiable incidents under Care Home Regulation 37. All members of staff have been checked under appropriate recruitment procedures now in force nationally (ie. references, application form, CRB/POVA check, probation, induction training, supervision). The home follows the Kent & Medway Policy for Adult Protection. A complaints’ procedure is in place. Service users are confident in expressing their views to members of staff, visitors and day centre staff. Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27 and 29 The premises are safe, comfortable and well furnished. Year-on-year improvements have enabled the environment to continue to contribute to the comfort and safety of service users. EVIDENCE: There are single bedrooms for all service users, a modern kitchen, a separate dining room, lounge, conservatory and garden. Bedrooms meet the needs of service users. New office facilities have been built over the rear garage. There are sufficient bathroom and toilet facilities. There are sufficient shared areas for staff, service users and visitors. Currently there are few specific disability aids and adaptations available for service users. If a service user required some form of additional care or adaptation, this would be identified examples were that a hoist was purchased for a service user (who no longer needs it because of improved health) and temporary 1:1 additional staffing was put in place. Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x These Standards were not assessed on this occasion. EVIDENCE: Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 40 and 42. The home is run in a way that ensures as far as is practicable the comfort and safety of service users. It is well managed and the interests of service users are identified and safeguarded as a priority. EVIDENCE: Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 19 The owners/managers are both qualified nurses (RGN and RM) registered with NMC (nursing and midwifery council). Rosemary McGinty’s first nursing qualification was “Registered Nurse for the Learning Disabled” and she has a diploma in counselling. Both owner/managers have significant experience in providing residential services for younger adults with learning and physical disabilities. The owner/managers maintain contact with organisations in the area which monitor developments in the care of people with learning and physical disabilities and those with mental health difficulties. The management approach of the home creates an open and positive atmosphere. Service users were relaxed, comfortable and at ease with visitors. There was evidence that efforts are made to encourage members of staff and service users to feel free to voice any concerns they may have. When service users returned in the evening, they quietly and purposefully went about their activities and they appeared to be relaxed. The owner/managers have undertaken a full review of the home’s staff training needs and employed a training consultant to facilitate this process. A computerised system for care plan records has been implemented. Members of staff have easy access to these records. The home’s written policies and procedures comply with current legislation and standards, covering the topics set out in Appendix 3 of the National Minimum Standards for Adults. Training in movement & handling procedures is provided for new and existing staff. The content of this training has been reviewed and updated by a training consultant (the outcome of this review was not assessed on this occasion). Written risk assessments are carried out in relation to premises, individuals and procedures. Portable and fixed appliance testing is carried out. Fire safety equipment is checked according to required frequencies. Fire drills are practiced and all fire safety routines are recorded. All visitors are required to sign in and out. The home has public liability insurance, a copy of which is displayed. Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 x Standard No 11 12 13 14 15 16 17 4 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Evas Folly Score 3 4 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x 3 x H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 21 No 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 Regulation None 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 None Good Practice Recommendations Evas Folly H56-H06 S23926 Evas Folly V227990 080605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent, ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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