Inspection on 10/01/07 for Four Seasons

This inspection was carried out on 10th January 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 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 Seasons 11/12/08

Four Seasons 04/01/06

Four Seasons 17/06/05

Four Seasons 14/02/05

Four Seasons 28/06/04

Four Seasons 09/02/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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 Four Seasons 104 Melbourne Avenue Dover Kent CT16 2JH Lead Inspector Julie Sumner Key Unannounced Inspection 10th January 2007 9:30 Four Seasons DS0000023202.V304429.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 Four Seasons DS0000023202.V304429.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. Four Seasons DS0000023202.V304429.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Four Seasons Address 104 Melbourne Avenue Dover Kent CT16 2JH 01304 226434 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) Mr Gary Thompson Mr Gary Thompson Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Four Seasons DS0000023202.V304429.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2006 Brief Description of the Service: Four Seasons provides care and support to three service users with a learning disability. The current fees for the service at the time of the visit range from £460 to £550. Information on the home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The e-mail address of the home is included in the previous page with other contact details. The home has three service users bedrooms accommodated on the first floor. On the ground floor there is a sitting room, dining room and kitchen. There is a spacious rear garden, a front garden and a drive at the side with parking. Local bus services into Dover are nearby. The home is situated on a main bus route to Dover. It is in a good position for service users to access local amenities and is in keeping with the local community. The home also has a vehicle for service users to go out. Four Seasons DS0000023202.V304429.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 and service users were given a little notice so that they could choose if they would like to participate and a convenient time was agreed. Four Seasons provides a comfortable, homely environment for service users with support to develop independence. The inspector visited the home to talk to service users and staff and view records and practices. The time spent in the home overall was just over 5 hours. Information was gathered for this inspection by a variety of means both prior to and during the visits to the home. When asked what they thought was best about living in Four Seasons one service user replied “ the staff, all of them” and named them all; one service user said they liked going out and another liked going on the holidays. The CSCI request information from the home routinely and the owner/manager provided all the information requested in the pre-inspection questionnaire prior to the inspection visit. Feedback questionnaires were sent out some time before the inspection visit. Feedback was received from service users and all comments were positive. There were no requirements made at the previous inspection and progress had been made on the recommendations. 4 recommendations were made as a result of this inspection. What the service does well: The home continues to provide a high standard of care and support to individuals. Service users said they like the people they live with and all get on well and they feel supported well by the staff. The home supports service users to attend a wide range of occupational and social activities in the community. Service users have been supported to change activities as their skills or needs have developed. Holidays are considered an important part of individual lifestyles and service users recounted several holiday stories; this time about their trip to Fuete Ventura in November. Service users said they had good support with their health. The home makes good use of community health services to make sure each individual is getting the right support. The home is warm and comfortable. Four Seasons DS0000023202.V304429.R01.S.doc Version 5.2 Page 6 The home has been flexible and responsive to service users needs and has listened positively to individual wishes. 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. Four Seasons DS0000023202.V304429.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 Four Seasons DS0000023202.V304429.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users have assessments that form the basis of their care and support. EVIDENCE: No new service users have been admitted since the last inspection. A sample of service user plans were viewed and discussed. These contained reassessments of individual’s current abilities and care manager reviews that form the basis for the service user plan. Four Seasons DS0000023202.V304429.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): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user plans are clearly written and contain a good range of information. Service users are given appropriate assistance to make decisions about their life. Risk assessments have been developed to incorporate a wider range of daily living opportunities. EVIDENCE: A sample of service user plans was viewed. Reviews were evident within the home. The manager had tried to contact the care manager for one individual but this was still outstanding. Both the service users and manager were keen to discuss progress that the service user had made towards independence and the next stage of support needs to be agreed within a risk assessed and structured framework. The care manager has been contacted for a future review date. Four Seasons DS0000023202.V304429.R01.S.doc Version 5.2 Page 10 Service users discussed how they have been developing their daily living skills. They said they participated in the meal preparation. How much, varied from person to person. One person said they sometimes cooked their own meal with help from the staff. The service user plans did include development in meal preparation and independent living skills. It would be useful to break these areas down into the tasks that each person is learning so that progress can be measured and learning continue to develop. A recommendation has been made for this. Service users talked about their lifestyles individually. There were examples where they have been discussing what they want to do in the future including on a day-to-day basis. Aspirations were included in the written service user plan. Service users had been asked their views as part of the ongoing quality assurance process and their wishes had been included in the service user plan together with a plan of support to enable them to achieve these. A recommendation has been made to revise the written format of the service user plan with each individual so that it is more person centred and accessible to them and using guidance from Valuing People. Risk assessments were viewed. Risk assessments have been designed to maintain safety but also to support developing social and daily living skills. Service users were enthusiastic about the skills they were developing. Four Seasons DS0000023202.V304429.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 this service. Service users lead an interesting lifestyle with opportunities for new activities in the local community. Service users are supported to maintain contact with their families. Service users are happy with the meals provided. EVIDENCE: Service users described their lifestyle and their interests. One service user had made several changes to their lifestyle since the last inspection and sounded very pleased with how they were spending their time. The written service user plan reflected the planned changes and how they were going to be achieved and it was possible to see evidence of this progressing. Each person is participating in different educational and leisure activities. One person has organised a part time work placement. Four Seasons DS0000023202.V304429.R01.S.doc Version 5.2 Page 12 Everyone had been given the opportunity to go abroad on holiday in November and said how much they had enjoyed it and where they want to go next year. Service users spoke about their families. They had all spent some time with their families at Christmas and had had a good holiday time. Contact is also maintained over the telephone and visits generally throughout the year. Service users said they choose how they spend their time and there are no restricted areas in the home. There is no set menu. Service users choose what they want. Staff know their preferences and these are taken into account when planning meals. Service users participate in the shopping and the meal preparation depending on their wishes and skills. What has been eaten including alternatives are written in each person’s daily record book. Four Seasons DS0000023202.V304429.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 good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their wishes and preferences will be taken into account in how they are supported. Service users benefit from good health care support and are able to access community health care services. Medication procedures are effective and medication is stored and administered correctly and safely. EVIDENCE: Service users said they happy with the way they are supported and feel that they are supported in the way they wish. Health care action plans have been designed as part of the care manager reviews. There are health care records including lists of appointments and any further treatment or intervention planned. Service users discussed their health, providing examples of when they have been in pain experiencing toothache and going to the dentist for treatment and for routine appointments such as flu inoculations. The chiropodist visits the home routinely and service users Four Seasons DS0000023202.V304429.R01.S.doc Version 5.2 Page 14 described recent interventions that they had experienced. They all said they felt healthy and knew what to do if there was a problem. Medication storage and administration practice was viewed and discussed. The home uses a monitored dosage system. All records were completed accurately and the storage unit was clean. Service users said they know which tablets they are on and why they take them but do not wish to self-administer. Four Seasons DS0000023202.V304429.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 this service. There is an effective complaints process. Service users feel they are able to discuss issues and are listened to. Service users are protected from harm by the policies and procedures in the home. Staff are knowledgeable about adult protection. EVIDENCE: Complaints policy and whistle blowing policy viewed. Service users are given opportunities to talk about their lifestyle and to express what they want. There are staff meetings and one-to-one supervisions available to discuss any issues that staff might have. Service users said consistently that if they had a problem they would go to the staff, giving examples of problems that had been sorted out and how satisfied they were with the outcomes. All staff have attended Adult Protection training. Sample of certificates was viewed. Four Seasons DS0000023202.V304429.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 good. This judgement has been made using available evidence including a visit to this service. The home is attractive, well maintained and clean. EVIDENCE: The home has a programme of redecoration and maintenance. The risk assessment and plans are in place for the extension. Service users talked with enthusiasm about the conservatory, which is also being built. Parts of the home have been redecorated and the main communal areas have newly fitted carpet. There are cleaning schedules in place. Infection control measures have been incorporated in a homely way. Four Seasons DS0000023202.V304429.R01.S.doc Version 5.2 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 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, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have a good rapport with service users. They are supportive and good humoured. Staffing arrangements are flexible and support service users well. The home has a good recruitment procedure to protect service users. There is a good range of training with staff encouraged to achieve qualifications to develop their skills and enhance the service provided. EVIDENCE: There have been no changes to the staff team since the last inspection. Staff files have been previously examined and all recruitment checks were in place. Training is ongoing. All mandatory training is up to date. All staff have NVQ level 2 and one member of staff is currently studying NVQ level 3. There was a discussion with the manager about keeping up to date with supporting people with learning disabilities nationally and locally, and utilising all facilities available. Service users do attend clubs in the community where they can meet people from other services and non-disabled people. A recommendation has been made for staff to attend person centred planning training. Four Seasons DS0000023202.V304429.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home. There is a clear vision and clear direction to develop the service. The quality assurance monitoring system has been developed and service users have participated in the content of the home’s development plan. The home has a good record of meeting health and safety requirements and has improved the policies and procedures around dealing with out of ordinary events and emergencies. EVIDENCE: The owner/manager has relevant qualifications and experience and has updated mandatory training. Four Seasons DS0000023202.V304429.R01.S.doc Version 5.2 Page 19 Viewed and discussed the home’s new quality assurance monitoring records and plans to develop the service. Feedback was evident from service users and their wishes had been taken into consideration in providing action plans to achieve their goals or make the changes they have requested. All the records and plans are written separately. The quality monitoring process needs to continue to be developed to include all aspects of the home and service. A report needs to be written to reflect what the service currently provides and bring all the aspects of current development together. A recommendation has been made to write a quality audit report and a development plan for the whole service. The EHO report for health and safety and food hygiene was satisfactory with no requirements or recommendations. The inspector viewed maintenance certificates and fire log. The home looked well maintained and decorated. Risk assessments have been written and appropriate action has been taken to minimise disruption and make sure service users are kept safe whilst the building work is ongoing in the home. Four Seasons DS0000023202.V304429.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 x 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 x 32 3 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 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Four Seasons DS0000023202.V304429.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Service users would benefit from part of the format of the service user plan to be redesigned so that it is more accessible for them and presented in a way that means more to them. Skills being taught as part of the service user plan need to be broken down into manageable tasks that can be achieved and the progress can be measured. Staff would benefit from attending person centred planning training. There needs to be a written annual development plan based on service users views on whether the home is providing what they want and striving for improvement. 2. YA6 3. 4. YA35 YA39 Four Seasons DS0000023202.V304429.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Office 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. Extracts may not be used or reproduced without the express permission of CSCI Four Seasons DS0000023202.V304429.R01.S.doc Version 5.2 Page 23 - 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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