Inspection on 11/12/08 for Four Seasons

This inspection was carried out on 11th December 2008.

CSCI found this care home to be providing an Good service.

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 10/01/07

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

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Southfields

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Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Four Seasons 104 Melbourne Avenue Dover Kent CT16 2JH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Lawrence     Date: 1 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Four Seasons 104 Melbourne Avenue Dover Kent CT16 2JH 01304226434 Telephone number: Fax number: Email address: Provider web address: gary.thompson847@ntlworld.com Name of registered provider(s): Name of registered manager (if applicable) Mr Gary Thompson Type of registration: Number of places registered: Mr Gary Thompson care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 5. The registered person may provide the following category/ies of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Date of last inspection Brief description of the care home Four Seasons provides care and support to five people. There is a spacious rear garden, a front garden and a drive at the side with parking and parking is also available in the street. The home is situated on a main bus route to Dover. It is in a good position for residents to access local amenities and is in keeping with the local community. The home also has a vehicle for residents to go out. The fees for the service range from 460 to 550 pounds per week. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection visit was notified to the home the day before to ensure that there would be someone available and started at 10:30 and finished at 15:30. We (the Commission for Social Care Inspection, CSCI) looked at various records in the home and also used information sent to us by the manager before the visit. This was the Annual Quality Assurance Assessment (AQAA). Information from the previous inspection was also referred to. We observed the residents who live at the home, noting how they reacted to staff and how relaxed and comfortable they were within the home. A walk round the house was undertaken and this included residents rooms. We made observations of staff interacting with, and supporting residents. We spoke to a member of staff and the manager. Four surveys were completed by residents and two members of staff also completed surveys and information from them is used in this report. Care Homes for Adults (18-65 years) Page 5 of 25 The previous key inspection was carried out on the 10 January 2007 and an annual service review was undertaken on 21 January 2008. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents individual aspirations and needs will be assessed. Evidence: The two most recent admissions were people well known to the home. They used to live in another home close by, owned and run by the same people. Their needs and wishes were reviewed prior to moving into Four Seasons. The manager told us that he would only admit any new resident after a full assessment of needs and wishes had been carried out by the placing authority. He would also ensure that he got to know someone before deciding about whether Four Seasons could meet their needs and he would ensure that any new person would get on with the existing group of residents. Care Homes for Adults (18-65 years) Page 9 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that their changing needs will be noted in their individual plans and that they will be supported to make decisions and take risks to enable as independent lifestyle as possible. Evidence: We looked at three care plans for this inspection. There are assessments in place relating to various things including emotional well-being, self-care ability and lifestyle choices and preferences and these are used to identify objectives to be achieved. Residents are involved in this process through discussions with staff, and the care plans contained various parts which had been signed by them. The two people we spoke to during the inspection confirmed that they were aware of their care plans. The plans also now contain residents expressed wishes for things to achieve over the next year such as going to Austria or having a new carpet. There were examples noted of residents making choices about everyday things such as what to wear and what food to eat, as well as choices about activities, going on holiday and what to spend personal Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: money on. The residents at Four Seasons all have individual accounts. They have different needs with regard to the level of support required. Staff have attended awareness training with regard to the Mental Capacity Act and are due to attend sessions relating to the Deprivation of Liberty Safeguards. The care plans contain risk assessments for various aspects of peoples lives and these focussed on reducing risk rather than stopping an activity altogether. Care Homes for Adults (18-65 years) Page 11 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities and involvement in the local community, as well as support for personal relationships will be provided for residents. They will benefit from having a healthy diet. Evidence: The people living at Four Seasons have a variety of interests and activities. They are supported to do all sorts of things in the community, both formal like attending day centres and informal such as clubs and discos. They use public transport if they wish (residents proudly said they have bus passes) and some people travel independently. Residents talked about the holiday in Tenerife planned for next March. They really enjoy their holidays and showed photographs of past ones. There were examples of the home supporting residents to maintain contact with family and residents spoke about this during the inspection and showed photographs of family and friends. The Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: care plans seen, as well as talking to residents and staff reflected that people are encouraged to be as independent as possible. One resident said that staff dont boss you about but they help you when you need it. Residents said they do their washing and keep their rooms clean. The care plans showed that everyone is encouraged to do what they can. There is not a planned menu at Four Seasons but decisions are made on the day. We saw a rack of fresh vegetables in the conservatory and residents said they liked the food. Staff confirmed that they knew residents likes and dislikes and this was noted in individual care plans. Care Homes for Adults (18-65 years) Page 13 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by the homes policies and procedures regarding medication and their physical and emotional needs will be responded to. Their preferences and requirements for support are respected. Evidence: The care plans contained guidance for staff about how to support people with their personal care. The daily records reflected that people get up and go to bed at different times although staff confirmed that support and advice would be offered if necessary. Health care needs are recorded and the records showed that health care professionals are involved both routinely and as required. Some of the residents have quite complex health care needs and the home has assessments in place to identify any changes. Nobody currently manages their own medication but the manager confirmed that this would be looked at regularly and for any new person moving in to the home. There are policies and procedures in place regarding medication. The medication administration sheets seen during this visit were appropriately completed. The home uses a monitored dosage system for medication. Storage was satisfactory. Staff have received training, with both external courses and in-house. Care Homes for Adults (18-65 years) Page 14 of 25 Care Homes for Adults (18-65 years) Page 15 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents views are listened to or ascertained, and acted on and there are procedures in place to protect them from abuse. Evidence: There is a complaints procedure in place and the information within the statement of purpose includes pictures and illustrations. There are occasional house meetings to give everyone an opportunity to say if they have any concerns. Residents spoken to during this inspection said they would talk to staff if they had any worries or problems. Those who completed surveys were also clear about who to talk to if they had any complaints. There are policies and procedures in place regarding adult protection such as the disclosure of abuse and bad practice (whistle blowing) and the management of residents finances. Staff have received training also. A member of staff confirmed their awareness of adult protection procedures and the records of other staff and the staff training records confirmed this also. The records show that the home has not received any complaints. Care Homes for Adults (18-65 years) Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home which is homely and comfortable as well as clean and hygienic. Evidence: We looked at parts of the home including some residents rooms, in the company of those living there. The home has had an extension and there are now two new rooms with en suite facilities. The personal and communal areas meet the needs of the people living in the home. Privacy and independence are encouraged and this was reflected in the care plans. The home is on a bus route and residents spoken to said they have bus passes and use the buses. Dover is close by, with all of its amenities. The home has transport available to enable residents to go out and about. Furnishings and fittings are domestic in style and because of its size Four Seasons is really very home like. The look round the house did not identify any health and safety issues. There is a garden available for residents to use and we were informed that now the building work has been completed there are plans to improve the garden. The home was clean and fresh on the day of the inspection. The laundry area is in the conservatory and there is still some work planned before this is finished. We were informed that the local council environmental health officer is satisfied with what is Care Homes for Adults (18-65 years) Page 17 of 25 Evidence: planned and has given time for this to be completed. We were informed that staff have received food safety and infection control training and this was reflected in records and by staff. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sound recruitment procedures and training already provided and training planned, will have a beneficial impact on residents. Evidence: Three staff have achieved national vocational qualifications at level 2, one person has almost completed this and another has just commenced this. One of the people with level 2 is currently undertaking level 3. Our observations of staff showed them to be positive and respectful towards the people they were supporting. There were times for encouraging people to do things and time for banter and jokes. Residents were observed to be comfortable with staff, talking or communicating with confidence. Two residents chatted informally to us during this visit and their comments reflected that they were satisfied with their routines and the way staff helped them. Staff who we spoke with were knowledgeable about the people they supported. The records of the recruitment procedure seen during this inspection showed that they are robust and include application forms, interviews, seeking references, undertaking criminal record bureau checks and terms and conditions of employment. Gary Thompson oversees the training opportunities to ensure that everyone is up to date. Care Homes for Adults (18-65 years) Page 19 of 25 Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well run home and their health and safety is promoted and protected. Evidence: The manager of the home, Gary Thompson has national vocational qualifications level 4 in management and care. He takes opportunities for other training such as Mental Capacity Act and first aid. Staff described him as approachable and someone you could have confidence in. He is also one of the owners and takes both responsibilites seriously. He has known the residents living at Four Seasons for some years and talks knowledgeably about them and their needs and wishes. Copies of formal questionnaires completed with residents, about how they feel about the home were seen on individual records. There are occasional organised or impromptu house meetings which involve residents and staff to talk about particular things or give people the opportunity to talk about what they want. There are comment slips available in the hallway for visitors to complete if they wish. Residents Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: and staff were given privacy in their discussions with us during this inspection. The AQAA was completed as required and forms part of the homes quality assurance. We did a spot check on some of the maintenance and service contracts and found them to be appropriate and up to date. The manager carries out fire safety checks and records them in a log book. Accident recording is in keeping with the Data Protection Act. Mr Thompson carries out a regular audit for health and safety and devises a list of jobs that might need doing. Staff training with regard to health and safety is kept up to date. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!