Inspection on 08/08/06 for Fame Care Ltd

This inspection was carried out on 8th August 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fame Care Ltd 04/04/08

Fame Care Ltd 31/07/07

Fame Care Ltd 08/11/05

Fame Care Ltd 26/08/05

Fame Care Ltd 20/01/05

Fame Care Ltd 16/08/04

Fame Care Ltd 30/01/04

Fame Care Ltd 05/12/03

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 HOME ADULTS 18-65 Fame Care Limited 24 Dunstall Gardens St Mary`s Bay New Romney Kent TN29 0QT Lead Inspector Wendy Gabriel Unannounced Inspection 8 and 10 August 2006 09:30 th th Fame Care Limited DS0000023421.V299261.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 Fame Care Limited DS0000023421.V299261.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. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fame Care Limited Address 24 Dunstall Gardens St Mary`s Bay New Romney Kent TN29 0QT 01303 874747 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) Beacon Care Holdings PLC Mrs Sarah Jane Hussey Care Home 4 Category(ies) of Learning disability (3), Physical disability (1) registration, with number of places Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The 1 resident with a physical disability should also have a learning disability 8th November 2005 Date of last inspection Brief Description of the Service: Fame Care is registered to provide care for up to four adults with a learning disability. Fame Care Ltd. is the registered Provider with the Registered Manager, Ms. S. Hussey in day-to-day control of the functioning of the Home. The home is a detached property set in a residential area of the seaside village of St. Mary’s Bay. All bedrooms are single and there is a large lounge dining area. Some car parking is available to the front of the property and there is an enclosed garden to the rear of the premises. Local facilities (shops, pub, GP, church and post office) are all within a short drive. Fees are in the range of £850-£920 per week. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector visited the home on the 8th for an unannounced inspection but had not entered the home as staff were seen helping the Service Users into the homes vehicle ready for an outing. The Inspector had watched this unobserved and was very pleased to see that the staff used the utmost kindness and skill in the process. The inspection continued on the 10th August. There were two Service Users living in the home at the time and there were two support workers on duty. The Registered Manager also manages another home nearby owned by Beacon Care and was not available during this visit. The duty rota was fully covered. Due to the long term sick leave by two permanent staff the two staff on duty at that time had been working daily 7am to 6pm for several weeks with no day off. Both said they did not mind and that they thought it was better for the Service Users to have continuity. However, this must be reviewed to ensure that staff are not overworked. The home was clean and tidy and presented as a comfortable and homely environment. What the service does well: What has improved since the last inspection? What they could do better: The Registered Manager also manages another of the homes owned by Beacon Care. At the time of the inspection, there was no support for her in the form of a deputy manager. This limits the amount of time available for the Registered Manager to be at the home. The recommendation for NVQ to be undertaken by 50 of the work force has been temporarily compromised by the long-term sick leave of two members of staff. Despite the staff goodwill in working for several weeks with no day off, the rota must be reviewed. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 6 Should the numbers of Service Users increase the rota must again be reviewed to allow appropriate numbers of staff to be on duty to meet the Service Users complex needs. As previously reported, consideration must be given to the provision of more appropriate office and storage areas and of visitors space that does not impinge on the communal space of the Service Users. Requirements are made for a suitable medication storage facility to meet current guidelines and for at least 50 of staff to obtain NVQ. Although staff training is well under way, staff development is to be maintained to meet the Sector Skills Council workforce training targets. 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. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 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 the following standard(s): 1,2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Suitable information is available to Service Users and their families to ensure their judgement to live in the home is informed. Staff confirmed that prospective Service Users are assessed prior to living in the home. EVIDENCE: Staff were able to inform the Inspector about the admission procedure whereby the Registered Manager and a member of staff will visit the prospective Service User to make an assessment. The care manager will also provide information for use in the care plan. The staff said that the ethos of the home was to make sure that the new Service User was compatible with the current Service Users. They stated that a Service User who was placed without a trial period did not meet the criteria of the home and eventually had to leave. There is written information for prospective Service Users and their families or advocates to make an informed choice about living in the home. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 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 the following standard(s): 5,7,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care plans are regularly reviewed to promote the welfare of the Service Users. Staff assist Service Users to make decisions about their daily routines. Risk assessments are managed and upheld by staff. EVIDENCE: A care plan was viewed and included a recent review from a care manager and details of health, psychological and emotional needs. There is evidence of health issues being attended to including informing or seeking advice from other Health care professionals as and when required. Risk assessments are in place. Separate files include regular reviews of immediate goals, health care appointments and outcomes and various charts to maintain health. A daily report sheet is completed by staff and includes Service Users dietary intake. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 10 The limited communication of the Service Users means that staff make choices for them. It was noted throughout the Inspectors visit that the staff were able to understand each Service Users body language and organised activities and meals accordingly to suit the individual. Staff have ready access to the files and confidently discussed the recording of information. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 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 the following standard(s): 12,13,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service Users are enabled to take part in suitable activities to meet their complex needs. Service Users often encounter friendly support when visiting places in the community. Family relationships are encouraged by the home. Staff respect Service Users rights in the home. Diets are chosen to meet known preferences indicated by Service Users. EVIDENCE: Service Users, because of their complex needs, do not undertake educational or work opportunities. Access to the local community is through trips out in Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 12 the homes own vehicle. Staff said that various places they visit were welcoming and friendly. Trips out are taken nearly every day, especially during the summer months. Annual holidays are not undertaken but a week is planned for daily outings that are paid for by Beacon Care. This summer they had visited Hastings and other local venues. A member of staff praised a ‘lady who worked at Herne Bay Pier’ who was excellent in her attitude to the Service Users. Staff discussed the wider community and said they felt it was important that the Service Users met people who did not come from other homes. Activities are limited by the physical and communication needs of the Service Users. An aromatherapist visits the home regularly and offers feet and hand massage. Families are welcome to the home but a private area for visitors is not available and meetings have to take place in the communal living area. There was evidence of fresh fruit and vegetables in the home. A member of staff said each resident had fresh fruit daily and one Service User was eating a piece of fresh fruit at the time the Inspector arrived in the home. Daily records indicated each Service Users meal choice for the day. Staff said that the food budget is limited and because there are currently only two Service Users, having enough to provide basic store cupboard supplies is difficult to budget for. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 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 the following standard(s): 18,19,20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Staff offer personal support that meets the needs of the Service Users. Healthcare is maintained by support from Health care professionals. A suitable medication storage cabinet will improve medication procedures. EVIDENCE: Personal support is given in private and the staff are able to maintain individual routines because they understand the Service Users preferences and dislikes. There was written evidence of input by Health care professionals. The home has a key worker system. Care plans indicate known preferences and health care needs that assist the staff make choices for the Service Users whose communication is limited. The home maintains medication policies and procedures. Medication is stored in a secure area but a requirement is made for a suitable lockable cabinet to be provided in place of the filing cabinet that is in use. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 14 Both staff confirmed that medication training is given and that only trained staff may administer medication. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 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 the following standard(s): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A complaints procedure is available to staff Service Users and visitors. Staff receive training in the protection of vulnerable adults. EVIDENCE: The home has suitable complaints policies and procedures. The Registered Manager has recently reviewed the complaint recording system to include action taken and outcome. There have been no complaints made since the previous inspection. Staff were able to clearly explain their actions should they believe abuse had occurred to a Service User. Staff undertake training in the protection of vulnerable adults including different types of abuse such as financial and physical abuse. The home maintains a whistle blowing policy. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 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 the following standard(s): 24,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home is suitable for the Service Users and is generally well maintained. The home is clean and hygienic. EVIDENCE: The premises were clean and tidy and hygienic. The laundry is a domestic style machine situated in a semi-enclosed space adjacent to the toilet. This is not ideal and a recommendation is made for this to be reviewed to explore a different position for the machine. There were two empty bedrooms at the time of the visit and these had new furniture and carpets. One empty bedroom has only 9.4 sq. metres of floor space. If the home wishes to use this room any constraints the room may have for a potential Service User must be indicated in the homes statement of purpose. When planning to use the room, the Registered Manager must consider the needs of the potential Service User who may use the room. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 17 The kitchen is small and dated with a cooker freestanding in a corner directly behind the door and a store cupboard with a badly fitting door. The kitchen was clean and tidy at the time of the inspection. A recommendation is made for a review of the kitchen facilities to make it more user friendly for the staff. As previously reported, consideration must be given to the provision of more appropriate office and storage areas and of visitors space that does not impinge on the communal space of the Service Users. The staff have taken great care in the decoration of the Service Users bedrooms and communal living area and have provided an attractive, cheerful and very homely environment for the Service Users. The garden is tidy and has colourful pictures and plastic ornaments to interest the Service Users. Some paving slabs leading to the shed were loose and the staff agreed to ask the maintenance man to fix these securely. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,35,36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Staff are aware of the parameters of their jobs. Staff training is ongoing but would improve by the home better understanding the Skills Sector Council. Staff receive supervision but could be better supported by the rota being reviewed. EVIDENCE: The recruitment procedure could not be fully inspected, as the Registered Manager was not available at that time. However, staff confirmed they had received CRB checks and an interview. Both staff had worked at the home for a number of years, one of them for approximately 15 years. Staff are aware of the parameters of their work and receive job descriptions. Staff understand the lines of accountability in the home and within the management structure. A list had been provided to the Inspector of training/update courses booked for staff including first aid, manual handling, infection control, fire safety and basic food hygiene. Further training has included understanding autism, epilepsy, bereavement, POVA and medication training. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 19 Although staff training is well under way, staff development is to be maintained to meet the Sector Skills Council workforce training targets. Staff confirmed that two members of staff were undertaking NVQ2. A requirement is made for at least 50 of staff to obtain NVQ. There was written evidence of staff having received supervision. As previously discussed in the report, the staffing levels are to be reviewed to meet the Service Users needs especially when the home is full and to ensure staff are not over worked because of covering for sick leave. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The Registered Manager has considerable managerial experience. Maintenance checks are in date, providing safe systems in the home. EVIDENCE: The Inspector has previous information that the Registered Manager holds the City and Guilds 325/03 in advanced management for care and at the previous inspection was commencing NVQ4. Service Users records are reviewed and maintained. The staff on duty were clearly aware of health and safety issues regarding risk assessments and maintaining a safe environment. Maintenance checks are in date and the fire book and systems regularly maintained. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 21 A representative of Beacon Care visits the home each month and provides a Regulation 26 inspection report to the inspection office. The Registered Manager is supportive to the staff who said she was very approachable, but because she is also Registered Manager of another nearby home was not always available unless they telephoned her. Requirements and recommendations made during the inspection are detailed in the report. Fame Care Limited DS0000023421.V299261.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 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 3 2 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 X 34 X 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 2 X X X 3 X X 3 X Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 23 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 YA33 Regulation 18 Requirement The home has an effective staff team with sufficient numbers and complementary skills to support service users’ assessed needs at all times, including obtaining the minimum of 50 staff with NVQ. A suitable medication storage cabinet is to be provided. Timescale for action 31/10/06 3. YA20 12 01/10/06 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 YA24 Good Practice Recommendations That a review of the kitchen and laundry spaces be undertaken with a view to improve facilities for staff use. Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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. Extracts may not be used or reproduced without the express permission of CSCI Fame Care Limited DS0000023421.V299261.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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