Inspection on 06/11/07 for Harbour House

This inspection was carried out on 6th November 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

Harbour House 06/06/06

Harbour House 27/01/06

Harbour House 06/07/05

Harbour House 28/02/05

Harbour House 18/10/04

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 Harbour House 6 Margaret Street Folkestone Kent CT20 1LT Lead Inspector Wendy Mills Key Unannounced Inspection 6th November 2007 11:00 Harbour House DS0000058814.V352014.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 Harbour House DS0000058814.V352014.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. Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harbour House Address 6 Margaret Street Folkestone Kent CT20 1LT 01303 211180 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) Mrs Tina Dennison Mrs Tina Dennison Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Owner does not engage in any other paid employment. Date of last inspection 6th June 2006 Brief Description of the Service: Harbour House is a small Home for four adults with a learning disability. It is situated in a residential area of Folkestone, with easy access to local facilities and amenities. The home is a mid-terrace Victorian house. The accommodation is on three levels. Each of the residents has their own room. There is a small, comfortable lounge and a separate dining room and kitchen. The home has two bathrooms, one of which contains the washing machine. There is a small enclosed garden to the rear of the property. Harbour House has a sister home, Anchorage House, in the same small street. Both homes are owned and managed by Mrs Tina Dennison and there is good interaction between the two homes. There are currently three residents living in Harbour House. The range of fees in this home is between £781 and £1,585 per week. Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced. It formed part of the inspection process of the Commission for Social Care Inspection (CSCI) under the Regulations of the Care Standards Act 2000. This report has been compiled using information gained during this visit and information supplied prior to the visit from a variety of sources including the Home’s own quality document, the CSCI’s required Annual Quality Assurance Assessment (AQAA), and feedback from relatives, visiting health and social care professionals and supporters of the home. During the visit residents and staff were spoken to both in private and during a tour of the home. In-depth discussion was held with registered manager and senior carer. A large proportion of the time spent during this visit was in the company of the residents who talked about their lives in the home and their interests outside the home. A tour of the home was made and documentation, including staff files and care plans, was examined. Both direct and indirect observation was used throughout the visit. The home meets the National Minimum Standards well and no requirement or recommendations were placed as a result of this visit. The residents lead busy and fulfilling lives and said that they like living in the home. The residents, staff and registered manager are thanked for the welcome they gave and their help throughout this visit. What the service does well: The home has a very friendly, open and easy-going atmosphere. The residents are relaxed and confident and live busy lives. They are involved in a wide range of leisure and educational facilities. The residents are very much part of their local community and maintain very good relationships with their neighbours. The way the home supports and cares for the residents is very good. Residents are involved in decision-making. They are encouraged to gain maximum independence and to recognise their responsibilities as citizens. The residents are supported to make informed choices and to lead active and fulfilling lives. The residents are treated with a great deal of respect and their privacy and dignity are preserved. The home actively promotes their health and well-being and liaises well with local GPs and other health care professionals. Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Harbour House DS0000058814.V352014.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 Harbour House DS0000058814.V352014.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. 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 this service. The home provides the residents, their relatives and supporters, with the information they need in order to make a decision about moving into the home. Appropriate pre-admission assessments are made. This ensures that only those residents who are suited to the home and whose needs can be met are admitted to the home. EVIDENCE: Since the last inspection a new guide to the service has been produced. This contains plenty of colour photographs and describes the kind of life a prospective resident might expect from the home. One resident has moved on since the last inspection. There is now one vacancy. There are sound pre-admission policies and procedures. The registered manager said that she intends to take her time to ensure that the right person is offered a place in the home. She talked about the importance of anyone new being able acceptable to the current residents who have lived in the home for three years now. Harbour House DS0000058814.V352014.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers the residents a good variety of choice in all aspects of their lives and supports them to make informed decisions. This promotes their independence and self esteem. EVIDENCE: Decision-making is documented in the care plans. Care plans contain up-todate risk assessments. Regular contact is maintained with care managers and regular reviews take place in conjunction with the residents. The residents said that they can make choices about the activities they want to do. Observation throughout this visit showed that they were all confident in making choices around the home and that staff supported them in this. The home is very good at finding new experiences that can be offered to the residents. For example, they have recently found a local curling team and one resident plans to join this. Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 10 Residents talked about the choices they could make. One said that he prefers to go out when the weather is nice and sunny but would rather stay at home if it is cold. Staff talked about the way they offer choices and encourage the residents to try new experiences. Harbour House DS0000058814.V352014.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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home supports the residents to take part in a wide variety of activities and to be responsible members of the community. This means that they are able to lead interesting, busy and fulfilling lives. EVIDENCE: The residents take part in a wide range of activities and the home is always on the look out for new and different experiences on behalf of the residents. Residents attend day centres, a gardening project, a community projects and visit fetes and bazaars. They go to the cinema, swimming pool and other leisure activities. One resident has recently taken up cycling and is regularly accompanied by a staff member on bike rides. Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 12 The residents are very much involved in the life of the local community. They are regulars at the local pub and one resident has been a member of their darts team for over three years. They help some elderly neighbours by putting out their wheelie bins and carrying their shopping for them. The home is very good at helping the residents to maintain links with friends and families. Relatives and friends can visit and share meals, transport is provided for visits and telephone contact is maintained. This year two relatives accompanied the residents and staff on a holiday. This meant that they were able to spend quality time without the worry of care-giving. There has been a holiday to the Isle of Wight and residents said they are going back soon to celebrate a special birthday. They said that they are really looking forward to this. Day trips are also organised frequently and some residents prefer these to going away on holiday. Residents spoke very enthusiastically about their holidays and outings. Residents plan their menus with the support of staff. Staff said that they try to encourage healthy eating. They were observed to do this in a very subtle and kind way. Once menus are agreed, residents help with the food shopping and one resident, in particular is very good at this, helping to carry the shopping and remember what is needed. Residents also help to prepare and cook meals and can help themselves to drinks and snacks as they wish. There was plenty of good quality food in the home on the day of this visit. Residents also enjoy pub meals and the occasional takeaway. They all have healthy appetites and were looking in very healthy on the day of this visit. Harbour House DS0000058814.V352014.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. 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. The home promotes the health and well-being of the residents and respects their privacy and individual wishes. This means that they residents can enjoy healthy lives and know that their dignity will be maintained. EVIDENCE: Indirect observation showed that personal care and support is given in a sensitive and discreet way that respects privacy and dignity. Personal care needs and preferences are noted in the care plans. The registered manager said that the home has developed very good links with care managers, GPs, dentists and specialist nurses and other health care professionals. Records confirm that their advice is sought appropriately and that this advice is acted upon. The residents attend well person clinics and other healthcare appointments. Records show that appointments are kept and staff take time to explain the importance of health promotion and self care to the residents. They have recently had their ‘flu jabs. Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 14 The residents are encouraged to take a pride in their appearance. They are given discrete prompts to ensure they maintain their personal hygiene. Conversation with the residents showed that they are aware of the importance self care and take a pride in their appearance. The way the home manages and administers medicines continues to improve. Eight members of staff have attended a ten-week (one day per week) course to learn more about the administration and management of medicines. Staff said that they are now much more aware of the consequences of poor practice in this area and feel much more competent in this area of care. They said that they had all tightened up on their practice and believe that they have reduced the risks involved in the administration of medicines still further. Medicines are stored safely and records are well maintained. The medicines cupboard is a good size and well organised. The temperature of this storage is monitored. The home continues to work closely with the learning disabilities and epilepsy specialist nurses and GPs to try to keep medication levels as low as possible. The care plans have been improved since the last inspection. They now contain records of behaviour as well as general health. Fits are being more closely monitored. Staff say that they use the care plans a lot and find them very useful in tracking the progress of each resident. Harbour House DS0000058814.V352014.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. 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. The home listens to the concerns and views of the residents and their supporters. It acts upon them, following clear policies and procedures. Staff are aware of the need to protect the residents from all forms of abuse. This means that the home does its best to protect residents from harm. EVIDENCE: Formal complaints policies and procedures are in place. Residents, their supporters and staff are fully aware of this but say they have not had to make any formal complaints. Residents said they can talk to staff if they are worried and indirect observation showed that they are all confident in expressing their wishes and that staff give good responses and explanations for all aspects of life in the home. Staff are aware of the Protection of Vulnerable Adults (POVA) policies and procedures. They are clear that they would have no hesitation in reporting any concerns about a colleague. Harbour House DS0000058814.V352014.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. 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 environment is well-maintained and decorated. It is clean and safe. This means that the residents have a pleasant and homely place in which to live. EVIDENCE: A tour of the home was made. The residents were pleased to show off their rooms and said that they are very happy with them. They have all personalised their rooms to reflect their interests, friends and families. Two bedrooms have been redecorated since the last inspection. The residents said that they had been able to choose the colour scheme. There was some minor damage to the home when the earthquake hit Folkestone earlier this year. This has led to some plaster falling off the walls and a few cracks to appear. This has been checked and interim repairs made. The home was safe, clean, comfortable and homely on the day of inspection. Harbour House DS0000058814.V352014.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff morale is good. There is a well-trained, stable and committed staff team who care for the residents very well. This means that the residents are supported by a cheerful and knowledgeable staff team. EVIDENCE: Staff rosters show that there are enough staff on duty on each shift. There is a low staff turnover. Staff confirmed that there are enough staff with the necessary skills to support the needs of the residents. The residents said that they like the staff and that they are kind. Conversation with staff confirmed that they like working in the home and are knowledgeable about the needs of each resident and about best care practice. Activity and staff rosters showed that there are enough staff on duty to ensure that scheduled activities are supported and that activities within the home are encouraged. All healthcare appointments are kept. Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 18 Inspection of a sample of staff files and training records showed that staff are receiving both statutory and specialist training. Recently eight staff members have completed a course in the management and administration of medicines. Others have attended training in epilepsy and diabetes. The documentation for staff monitoring has been greatly improved since the last inspection. This means that the registered manager now has a better overview of the training and supervision that takes place place. Staff said that there is good communication in the home and that they very much enjoy their jobs. They said that they can talk easily to the manager or deputy manager and that there is open discussion about the way things are managed in the home. Discussion with the registered manager showed that she takes a great deal of trouble over the recruitment process. The staff files that were examined contained good evidence that all appropriate pre-employment checks are made prior to offering employment at the home. In addition, there is a three-month probationary period during which there is close monitoring. . Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 19 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. 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. The home is well managed and record keeping has significantly improved. The views of the residents and their supporters are listened to and acted upon. This means that the home is run in the best interests of the residents. EVIDENCE: Tina Dennison, the registered provider/manager is an enthusiastic and friendly person who is clearly committed to creating a positive environment for the residents and staff. Staff say that she is easy to talk to and that she acts on their suggestions and concerns. Indirect observation of her interaction with the residents showed that she has an easy and friendly relationship with them all. They are very comfortable talking to her and seek her out to tell her about their daily experiences. Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 20 There has been a significant improvement in the way documentation is organised in the home. The management documentation has been completely reorganised and is now much clearer. A well-equipped and spacious office has been created at Anchorage House, the sister home of Harbour house. This is situated three houses away from Harbour House. Better use is now being made of computer based systems and the security of storage of management records has improved. It was good to note that the registered manager was able to put her hand quickly to all documentation requested during the course of this visit. Quality assurance processes in the home are now more formalised and better records of consultation with residents and their supporters are now kept. In addition, the CSCI’s required quality document, the Annual Quality Assurance Assessment (AQAA) had been completed. No health and safety hazards were noted during this visit. Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 21 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 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 4 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 X 3 X 3 X X 3 X Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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 Harbour House DS0000058814.V352014.R01.S.doc Version 5.2 Page 24 - 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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