Inspection on 29/09/05 for Four Nevill Park

This inspection was carried out on 29th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Four Nevill Park 30/09/09

Four Nevill Park 09/07/08

Four Nevill Park 31/05/07

Four Nevill Park 29/08/06

Four Nevill Park 08/02/06

Four Nevill Park 04/01/05

Four Nevill Park 13/05/04

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

CARE HOME ADULTS 18-65 Four Nevill Park 4 Nevill Park Tunbridge Wells Kent TN4 8NW Lead Inspector Maria Tucker Unannounced Inspection 29th September 2005 09:30 Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 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 Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 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. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Four Nevill Park Address 4 Nevill Park Tunbridge Wells Kent TN4 8NW 01892 519520 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) Opus Living Vacant Care Home 24 Category(ies) of Learning disability (24) registration, with number of places Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2005 Brief Description of the Service: Four Nevill Park is a large detached Victorian property standing in its own grounds situated in a private road in an elevated position. It is registered for 24 service users and has been developed to offer care for people with a diagnosis of Autism or Aspergers Syndrome. It offers sixteen single rooms in the main house and six single and one double independent flat. The flats offers accommodation for those service users who require the minimum of support and are staffed independently of the main home. The home is located on the outskirts of Tunbridge Wells; the town centre is a short distance away with easy access to public transport. Shops, pubs, post office and church are within easy walking distance of the home. There are large gardens, mainly laid to lawn, to the front and rear of the home that can be used by service users. There is car parking to the rear of the building. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The inspection lasted from 10.35am until 3.35pm. Time was spent meeting the manager (pending) and area manager going through various records and documentation. About one hour was spent meeting service users. A partial tour of the premises was undertaken. There had been a planned announced inspection that was cancelled due to the timing of the new ownership. As some of the comment cards had been received these will be considered and included as part of this inspection. Comments received included: • “Overall I have been happy with my care at 4 Neville Close” • “4 Neville Park has undergone several changes in recent months, I am currently very happy with the new direction they are taking” • “There needs in my opinion to be more staff at weekends, so not left in there rooms” • “…is very happy at Neville Park. I don’t have any complaints. The staff are all very caring, especially Matt and Liza” • “I like living at Neville Park, I like living in my own apartment. I look forward to the future living in my apartment” Due to the nature of some of the service, it is difficult to reliably incorporate accurate reflections of the service in the report. Some judgements about quality of life and choices were taken from direct conversation with service users and observation followed by discussions with staff and evidencing records held in the home. The home is under new ownership as from July 1st 2005. The home has no plans to close or relocate. It is acknowledged that the new owners have had little time to assess and make the major improvements required by this service, as highlighted in previous inspections. The home has a new manager whom commenced the week of the inspection. This inspection was therefore a basic inspection and has targeted areas that are considered to pose a risk and to begin to raise the standard of care so that it provides a good quality of life for the service users. Initial meetings with the new providers and the CSCI have proved beneficial in that the owners have confirmed in writing an action plan of their intention for improvements and investments for 4 Neville Park. What the service does well: Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 6 Improvements to the environment such as new lights being fitted; painting and redecorating have begun. There have been new care plans that are being introduced, which are informative and person centred. The new manager has a good level of understanding and insight into the service user group and has discussed some ideas and aspirations as to the commitment she has made to work in the home, with service users and staff to implement the vast changes that are needed. What has improved since the last inspection? What they could do better: The home has lacked direction and leadership. With the appointment of a manager it is anticipated that this will be resolved. The service users and staff need a period of stability where they can adjust to the changes and allow for discussions and time for the new owners and manager to decide the future, purpose and function of the home. The home is currently one home providing two different services, to two different service users groups, by two staff teams. Give greater choice for service users of which staff from which team they would like to receive support from. Adherence to the Data Protection Act 1998, in relation to the information currently on view in the office at the front of the house. Firming up of the recruitment and selection policy and procedure. The admitting of new service users in the home following a full assessment, which considers fully specific needs, including accommodation i.e. individual apartment or main unit and level of support. Consideration to the compatibility of perspective service user’s and those currently living at the home. A fully completed statement of purpose and service users guide. Mandatory and other specific training to be identified and undertaken. The staff rota to include all persons working in the home and their capacity. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 7 Risk assessment formats to be reviewed and made more comprehensive and usable. 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. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 8 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 Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 9 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, 3, Service users do not have the information available to them to decide if they would like to move in the home. Service users cannot expect to have their needs fully anticipated, or met, when moving into the home. EVIDENCE: There is no current up to date statement of purpose and service users guide. A service user had been admitted into the home following an assessment, which did not fully take into account either their individual needs or the compatibility with other service users. A service user expressed that they understood that this person in question had problems but was very apprehensive following some incidents stating, “I still keep looking over my shoulder”. An adult protection alert has been raised following a separate incident with another service user. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 10 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): 6, 7, 9, 10 With the implementation of the new care planning systems service users have more choice, flexibility and involvement. EVIDENCE: The home has introduced a new format for care planning systems taking a ‘client centred approach’ in a service user life plan. The ones that have been completed were very comprehensive and informative. The new care plans indicated choice and opportunity for service users in making decisions. A service user spoken with discussed how they had chosen to seek an alternative independent living accommodation and that staff knew and were supportive in this. That they have an advocate that supports them. Service users spoken with talked about the support they receive one service user commented on the support offered with cooking stating, “I read the instructions and cook, staff support”. Another stated “Sometimes I get the staff to help me clean did a big super clean with me last week”. The risk assessment formats are not as comprehensive or appropriate as they could be which limits the use of these within the care plan. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 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): 11, 12, 15, 17 Service users who are living semi independently are supported to maximise their independence. Service users are supported to choose the menu. EVIDENCE: Some service users live in semi-independent flats where they are supported with independent living tasks. Service users spoke of the support they received and their aspirations of doing more or moving out into the community. Service users spoke of the contact they had with families and friends this included visits to their family home and having visitors to the home. The comment cards indicated a good level of involvement from friends and relatives. One service user discussed the support they received, explaining how they had “some help to help support me” and that they had agreed their support through discussions with staff and were currently “building up a relationship” with the person that supports them. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 12 Evidence from care plans, discussions with service users and the general coming and going throughout the inspection indicated that education and occupation for service users is individual and varied. The menu was varied and the dinning room area had been decorated making it a more congenial place to eat. Service users were supported through discussions to choose the menu. Some service users are given money so that they can plan, prepare and shop for their own meals. A service user spoke of how they had been provided with an organic pizza the staff knew that this was their preference. It has been a difficult time for theses service users as the day this money arrives has changed due to administration of the new providers. This has obviously caused anxiety. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 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 Service users have staff teams that are specifically identified to offer support according to the service offered and not the choice of the service user. EVIDENCE: The home currently has two staff teams who either support the service users in the residential side or in the individual apartments. This does not allow for service users to have a greater choice of staff that is able to support them. One service user spoke of how they would like a staff member who was not a ‘flat staff’ to support them as they liked them. That they have sometimes asked them. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23, Service users can feel confident that they will be protected through the staff implementing the adult protection procedure. EVIDENCE: During the inspection two service users expressed dissatisfaction because their money for purchasing food was given out on a different day. The manager and staff explained that they were dealing with this as a complaint as they fully understood the impact that this has had. The inspector has agreed that at the next inspection, how complaints are received and acted upon by the home will be discussed. The home has currently one adult protection alert that has been raised and in the process of being managed. Staff at the home discussed the incident and situation with the inspector and raised the alert. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Service users can expect the home to be refurbished and redecorated making it more comfortable and suitable. EVIDENCE: Some improvements have already been made such as new lighting in corridors; painting and decorating and broken windows replaced. It has been agreed that the environment does need to be updated so that it is suitable for its stated purpose; accessible, safe and well maintained; and meets service users individual and collective needs in a comfortable and homely way. That this would be inspected in the next inspection as the new manager and providers had begun identifying what needs to be done. This is in the process of being addressed. During the inspection decorating was in progress and PAT testing of equipment done. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Service users can expect to be supported by a staff team that has not all been trained to support them appropriately. EVIDENCE: Service users spoke well of the staff and the interaction between staff and service users was seen to be one of mutual respect and understanding. There are specific staff roles and responsibilities. The rota does need to identify the exact staffing hours worked and the capacity of staff. There was evidence of recent training having taken place and been booked. The staff training matrix and certificates of training in staff files evidenced that a full appraisal of staff training needs must be undertaken so that mandatory and other training is identified and planned for. The new owners have a training coordinator whom it is anticipated will support the home with this. A new staff member has started. The recruitment policy and procedure was not fully followed in that adequate references were not received. The staffing levels for a service user currently experiencing difficulties was not adequate to meet their needs. Another service user who has been presenting challenging behaviour during the inspection was seen to have remained in the hallway on their own without being supported by staff. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 17 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): 41, 43 Information relating to the home is not always stored in accordance to Data Protection Act 1998. EVIDENCE: Information relating to the home is on full view from the windows outside of the front door. The office upstairs did have locked cabinets where service users information was kept secure and there was no information pinned to the walls that breeched confidentiality. The new providers have gone through the process with the CSCI of taking over ownership of the home. During this process an action plan has been submitted for proposed improvements and investments to 4 Nevill park. Monthly Regulation 26 visits have been conducted. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 18 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 1 X 2 X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 2 2 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Four Nevill Park Score 2 X X X Standard No 37 38 39 40 41 42 43 Score X X X X 2 X 3 DS0000023940.V255099.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? N/A 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 32.1 35.1 Regulation 18 (1) (a) Requirement The registered person shall ensure that at all times suitably qualified persons are working in the care home in such numbers as are appropriate for the health and welfare of service users. The registered person shall maintain in the care home a copy of the duty roster of persons working at the care home, and a record of whether the roster was actually worked. The registered person shall compile in relation to the care home a written statement referred to as “the statement of purpose” and “the service user’s guide”. Timescale for action 10/11/05 2 YA 33 17 (2) Schedule 4, 7 10/11/05 3 YA 1.1 YA 1.2 4(1)a-c 5(1)a-c e,f 10/11/05 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 YA. 6 Good Practice Recommendations It is recommended that the new care planning formats DS0000023940.V255099.R01.S.doc Version 5.0 Page 20 Four Nevill Park 2 3 4 5 YA 34.2 YA 9.3 YA 18.7 YA 3 that have been introduced for all service users. It is very strongly recommended that the recruitment policy and procedures and firmed up and followed. It is strongly recommended that a range of risk assessment formats are devised made available. It is recommended that a review be made of the staffing arrangements so that service users are able to have more flexibility in the choice of staff to support them. It is very strongly recommended that prospective service users have the appropriate levels of care and support to meet their needs that have been assessed. That consideration is made to the compatibility of the service users already at the home. Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 21 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. Extracts may not be used or reproduced without the express permission of CSCI Four Nevill Park DS0000023940.V255099.R01.S.doc Version 5.0 Page 22 - 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. 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