Inspection on 13/12/05 for Healy Drive , 1

This inspection was carried out on 13th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Healy Drive , 1 31/08/06

Healy Drive , 1 15/02/05

Healy Drive , 1 01/07/04

Healy Drive , 1 19/02/04

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Healy Drive , 1 1 Healy Drive Orpington Kent BR6 9LB Lead Inspector The premises are kept clean, hygienic and free from Unannounced Inspection 13th December 2005 10.30 Healy Drive , 1 DS0000006947.V268376.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 Healy Drive , 1 DS0000006947.V268376.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. Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Healy Drive , 1 Address 1 Healy Drive Orpington Kent BR6 9LB 01689 870216 01689 891407 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) The Catholic Children`s Society Miss Joanna Tripp Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 8 Adults of either sex with a learning disability to include 2 young females whose dates of birth are 6/11/80 and 2/01/80 within the category of LD 10th August 2005 Date of last inspection Brief Description of the Service: Cabrini, 1 Healy Drive is part of the Catholic Children’s Society and provides care for eight young Adults with a Learning Disability. The home is a large modern detached house situated in a quiet cul-de-sac and is part of a project consisting of two group houses and one other house used as a day centre for the residents that live in both of the homes in the group. Clients can go to the attached daycentre or elsewhere if they choose. All the residents have their own spacious bedroom, there is a comfortable sitting room, large dining room and the garden is attractive and well maintained, it has a sensory area with easy assess and an area of decking by the French windows enabling outside dinning. The house has its own transport so the service users have trouble-free access to the community. Healy Drive , 1 DS0000006947.V268376.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 and initially the inspector was facilitated by a support worker and later by the Manager who started her shift early because of the inspection. During the inspection all staff members on duty were open and friendly and the Service Users were insistent on speaking to the inspector and gave a good report of the staff and their home, all expressed satisfaction. The house is well decorated and has a welcoming atmosphere, there where pictures, photographs of the Service Users and ornaments throughout the building giving the impression of a comfortable relaxed home. What the service does well: 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. Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 6 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 Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 7 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): A new Service User has moved into the house since the last inspection and so the inspector was able to assess all standards 1 to 5 on this occasion. There is sufficient information available for the Service User to make an informed decision about the home and was given the opportunity to “test drive” the home. EVIDENCE: The homes statement of purpose and is available in a clear and comprehensive format and the Service Users are provided with a contract that sets out the terms and conditions of the placement. Three Service Users files were looked at during this inspection. There were community care assessments and written contracts, but no evidence that the manager had given the Service User assurance that the home will meet their needs and aspirations as set out in regulation 14(d). Please see requirement 1 Schedule 3 sets out information that must be kept in the home in respect to each Service User it is recommended that all this information be incorporated into the care plan or included in each individuals folder for ease of access. Please see recommendation 1 The new service user was given the opportunity to visit the home for tea visits and overnight stays before deciding to move in permanently. Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 8 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): Care plans were in place that reflected the Service Users changing needs and personal goals, staff support them to make decisions about their lives and risk assessments have be carried out to enable Service Users to take acceptable risks in their lives. EVIDENCE: Care assessments are reviewed regularly; one Service Users assessment was reviewed in November 2005. This assessments sets out changing needs and explores personal goals and the Service User is included in the review and are encouraged participate in all aspects of life in the home. There are various risk assessments in place, including helping to prepare meals, that supports the manager’s and staff member’s assertions that Service Users are supported to take risks as part of an individual lifestyle. All personal information is stored in the office in locked filing cabinets. Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 9 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): All standards were explored in this section. Service Users go to a day centre or college to enable them to continue personal development as well as having regular outings that includes eating out, shopping and going to the cinema. The house has a mixture of ethnicity and religious backgrounds within its Service User group but this mixture is not reflected within the house. EVIDENCE: Service Users are given the choice of attending the day centre on site, another centre or attending a college to continue their personal development and maintain peer appropriate activities, the annual review highlight areas of development needs and aspirations, action plans are developed from them. The house has a mixture of ethnicity and religious backgrounds within its Service User group but this mixture is not reflected within the house, there are few clues in the communal rooms or bedrooms that would indicate the rich cultural mix of it’s occupants. While talking to staff it became apparent that training was needed in understanding different religions and cultures, it is recommended that ways are found to help the Service Users to explore and recognise their own and others cultural and religious origins and that staff receive appropriate training. Please see recommendations 2 & 3 Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 10 There is a range of leisure activities within the home and one of the Service Users was keen to show the inspector his collection of music CD’s and videos as he chose a CD to put on the music centre. There was a computer for the use of the Service Users that has programs that are designed to suit their abilities, it is used by all and particularly enjoyed by one person. Family members often visit the house and the house recently held a coffee morning that family and friends were invited to. Some Service Users visit their family home at weekends and others go on holiday with their families. During the inspection staff responded to, and spoke of the Service Users in a respectful way, they consulted them and encouraged them to make decisions about what they were going to have for their evening meal. The dining area way spacious and comfortable and the food that was being prepared looked and smelt inviting, there was ample food in the fridge and freezer and the menus, that the Service Users had help to choose, were varied. Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 11 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): Service User needs and personal preferences are reflected in their care plans, all are registered with the local doctor the medication is handled in a way that is safe and there are policies in place that reflect a caring and supportive ethos within the home. EVIDENCE: The Service Users needs and personal preferences are reflected in their care plans and the two staff members the inspector interviewed showed awareness of individual needs and assured her that they would always seek ways to enable the Service User to make decisions and choices and would respect their views and choice. One of the Service Users has a hearing impairment and staff are trained to communicate in a way she able to understand and she can make her needs known and is understood by staff. All the Service Users are registered with the local GP and attend the doctor when needed. Another Service User has recently developed new behavioural challenges and has been referred to specialist services for assessment and investigations into the cause. None of the Service Users self medicate and all the medication was stored in a suitable, locked cupboard that was clean and tidy and the medication inspected was all within the expiry date. The inspector was not able to access whether Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 12 the medication recording sheets were in order or if they contained photographs of the Service Users, a previous requirement, as they were not in the house as they had been taken with the Service Users to the day centre. This will be monitored at future inspections. The user group is relatively young and have no serious health needs but the manager assured the inspector that should anyone should become seriously or terminally ill they would nursed within the home as long as it was practical to do so and as long as it fell to be within the best interest of the Service User and the skills and abilities of the staff group. Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 13 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): These standards were not assessed on this occasion. EVIDENCE: Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 14 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): All standards in this section were judged in this section, the house is clean and hygienic and has a homely feel and is suited to the needs of the Service Users and promotes independence and reflects their chosen lifestyles. EVIDENCE: The house is well decorated, bright and spacious. It is furnished comfortably to a high standard and there are pot plants, pictures and ornaments around the house. It has a welcoming aspect and hallways, landings and exits where free from obstruction. All radiators now have covers, a previous requirement. All the Service Users bedrooms are furnished to requirement including chairs except for one of the rooms that has large cushions as preferred by the Service User. They are clean and individually decorated and each room has personal belongings, pictures and ornaments that reflect the Service Users character and personality. Service Users personal property is also found in the communal rooms indicating that the shared spaces compliment and supplement people’s individual rooms. Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 15 All the bathrooms are private, clean and free from unpleasant odours. The bathroom on the ground floor is in the process of being converted to be wheelchair accessable with toilet, sink and shower. On the day of the inspection two domestic staff were working in the house, their time is shared between the project, the house was clean and tidy. The laundry is accessed only through the kitchen potentially causing soiled articles, clothing and infected linen to be carried through areas where food is stored and prepared. The manager assured the inspector that risk assessments have been done and guidelines have been put in place to avoid contamination in the kitchen. The inspector understands that this has been a longstanding arrangement, however it is a requirement that the Environmental Health Officer is consulted and his findings are acted on if necessary, the inspector must be informed of the outcome and sent a copy of the report. Please see requirement 2 and 3 Healy Drive , 1 DS0000006947.V268376.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): The inspector was unable to assess standards 31 to 34 fully as staff records are still not held in the house but discussion with staff indicated that there is a full and varied training program is in place and it is accessed by staff. EVIDENCE: It is acknowledged that there are difficulties in storing sensitive and confidential information relating to the staff group in an unsecured environment and having them available for inspection at any time of day or night irrespective of the availability of the registered manager, arrangements must be sought that would satisfy both the need to uphold staff confidentiality and the requirement that the Regulatory Inspector is able to ascertain that the Service Users are supported and protected by the homes recruitment policy and practice by being able to inspect records related to staff members as set out in schedule 2. This is a restated requirement. Please see Requirement 4 The inspector met with two staff members and both assured her that they had contracts that set out their roles and responsibilities, that they were expected to work a probationary period, that they were asked to furnish names for two references, one to be from a previous employer and that they were subject to an enhanced CRB prior to taking up post. They appeared knowledgeable of the needs of the Service Users and issues that may affect them and confirmed that they received effective supervision from the Manager and her Deputy. Healy Drive , 1 DS0000006947.V268376.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): All of these Standards were assessed at this inspection. The house appeared to be well run with Service Users and staff confirming that the manager was approachable and would always make time to speak to anyone. Policies and procedures inspected were detailed and the recordkeeping and recording was acceptable. EVIDENCE: At the time of the inspection the home was calm and the Service Users appeared happy and four of them were keen to talk to the inspector and show her the house, to talk about the people who work with them and the manager. They all expressed satisfaction with the support staff and the manager. I was shown bedrooms by two of the Service Users and they were pleased and excited to show off their rooms and to talk about what they have done and how they like living in the house. Staff members that were interviewed believed the manager to be able and approachable. They talked about supporting the Service Users to achieve Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 18 personal goals and giving them as many opportunities as possible to act independently and make informed choices. The manager has not yet completed her NVQ4 or Registered Managers Award and this will be a restated requirement. Please see Requirement 5 No regulation 26 reports have been received at the commission and it is a recommendation that a copy should be sent to CSCI once they have been carried out and given to the house. Please see requirement 6 On inspection the fridge and freezer log books, although completed on a daily basis, recorded that the fridge thermometer was broken so the temperature could not be recorded from 15th November until the day of the inspection. The manager explained that a new thermometer had been obtained but proved to be faulty. Please see requirement 7 The laundry is accessed only through the kitchen potentially causing soiled articles, clothing and infected linen to be carried through areas where food is stored and prepared. The manager assured the inspector that risk assessments have been done and guidelines have been put in place to avoid contamination in the kitchen. The inspector understands that this has been a longstanding arrangement, however it is a requirement that the Environmental Health Officer is consulted and his findings are acted on if necessary, the inspector must be informed of the outcome and sent a copy of the report. Please see requirement 2 and 3 One of the fire extinguishers on the first floor landing was found not have been dated as checked during the last fire equipment check, this implies that it was missed, it is recommended that this particular extinguisher is checked by a competent person. Please see Recommendation 4 A random sample of the Service Users individual purses was checked along with the recording books. The totals were found to correspond with the recorded amount. When asked the manager was unable to produce particular receipts that corresponded to an entry in the book. It is recommended that an organised system be developed so that receipts can be easily identified. Please see Recommendation 5 Each purse should have a numbered tag that has to be removed before the bag can be opened, it is practice that it is recorded in the money book each time the purse is opened, by who and when, then a new tag is placed on the bag and it’s number recorded in the book. This is done to leave a paper trail of who has accessed the money. During the inspection some of the bags did not have the yellow tags in place, therefore leaving them insecure. It is required that Service Users rights and best interests are safeguarded by the home’s polices and procedures, and in this case practice and procedures are not working to protect the Service Users from financial abuse. A requirement has been made that the house procedures for dealing with the Service Users money is reviewed and that staff are made aware of the importance of following procedure and the consequences of failing to do so. Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 19 The manager must audit coherence to guidelines and procedures within the house. Please see requirement 8 Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 2 3 3 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 2 LIFESTYLES Standard No Score 11 3 12 2 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 2 2 2 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Healy Drive , 1 Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 2 2 3 DS0000006947.V268376.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA3 Regulation 14(d) Requirement The registered person can demonstrate the home’s capacity to meet the assessed needs (including specialist needs) of individuals admitted to the home and put this in writing to the Service User prior to them moving into the house. A copy of this letter must be kept on Service Users file. The manager must ask the environmental Health Officer to inspect the kitchen and laundry arrangements and she must act on his recommendations. The Registered Person must forward the environmental Health Officers report and recommendations to the Commission. The Registered Person must ensure information and documents in respect of persons carrying on managing or working at a care home as stated in Schedule 2 in the Care Home The Registered Person must obtain relevant and acceptable qualifications as set out in regulation 9(b) The Registered Provider shall DS0000006947.V268376.R01.S.doc Timescale for action 15/04/06 2 YA30 13 15/04/06 15/04/06 3 YA30 13 4 YA34 19 15/08/06 5 YA32 9 15/04/07 6 YA39 26 Healy Drive , 1 Version 5.0 Page 22 7 8 YA42 YA41 13 12 supply a copy of the report done, as set out in Regulation 26, to 15/02/06 the Commission. The Registered Person must provide a suitable fridge 01/02/06 thermometer at all times. The Registered Manager must review the house procedures for dealing with the Service Users money and ensure that staff members are made aware of the 15/04/06 importance of following procedure and the consequences of failing to do so. The manager must audit coherence to guidelines and procedures within the house. 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 YA2 Good Practice Recommendations Schedule 3 sets out information that must be kept in the home in respect to each Service User it is recommended that all this information be incorporated into the care plan or included in each individuals folder for ease of access. The Registered Manager should look for ways to help the Service Users to explore and recognise their own and others cultural and religious origins It is recommended that all staff members receive training in understanding different religions and cultures It is recommended that a competent person check extinguishers that may have been missed during the last service. It is recommended that an organised system of storage be developed so that receipts can be easily identified. 2 3 4 5 YA12 YA31 YA42 YA40 Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Healy Drive , 1 DS0000006947.V268376.R01.S.doc Version 5.0 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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