Inspection on 21/09/05 for Hevercourt

This inspection was carried out on 21st September 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hevercourt 26/03/08

Hevercourt 28/02/07

Hevercourt 24/01/06

Hevercourt 21/10/04

Hevercourt 11/05/04

Similar services:

Wingham Court

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

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

CARE HOMES FOR OLDER PEOPLE Hevercourt Goodwood Crescent Gravesend Kent DA12 5EY Lead Inspector Ruth Burnham Unannounced Inspection 21st September 2005 08:30 X10015.doc Version 1.40 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 Hevercourt DS0000023955.V249441.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 Older People. 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. Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hevercourt Address Goodwood Crescent Gravesend Kent DA12 5EY 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) 01474 363690 Kent Community Housing Trust Mrs Christina Clark Care Home 46 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (21) of places Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st October 2004 Brief Description of the Service: Kent Community Housing Trust is a non-profit making Trust. Hevercourt is one of 22 residential care homes owned and run by the Kent Community Housing Trust (KCHT) in the Kent and London areas. It holds Investors in People Award and has an ISO 9002 Quality Standard Accreditation. The general aim of KCHT, as expressed in its brochure, is to provide quality services which are flexible and affordable, meet the needs of individuals, preserve dignity and promote independence, and develop opportunities for fulfilment for people needing housing with care and for those who need care and support within their own homes. Hevercourt is a large detached premises surrounded by lawns and gardens and close to the A2 junction at Singlewell. It offers 37 single and 5 double bedrooms. There is a shaft lift serving all three floors with bedroom accommodation on the ground, first and second floors and other services (i.e. kitchen, lounges, smoking room, visitors room, hairdressing salon, activities room, medical room and staff room) on the ground floor. The Home is registered for 21 Older People and 25 Older People with a Mental Infirmity. Hevercourt is located on the outskirts of Gravesend and is within easy walking distance for most service users of shops and other public amenities. However, service users have good access to a KCHT minibus. There are extensive car parking facilities at Hevercourt and service users have access to two safe enclosed gardens at the rear. Hevercourt DS0000023955.V249441.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 carried out by one inspector who was in the home from 08.30 to 13.30, during this time a number of staff and service users were observed and spoken with around the home. Feedback was given to the assistant manager and operational manager. 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. Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users cannot be confident that their needs will be met on admission to the home EVIDENCE: Service users cannot be confident that their needs will be met on admission to the home in that there is very little information recorded about them prior to their arrival. Set admission procedures put in the Trust’s quality manual are good and forms provided for assessment are thorough, however, the home is not following these procedures in that the pre admission assessment is not being completed at the pre admission visit, only referral forms are used. A service user was being admitted on the afternoon of the inspection and even the referral forms were incomplete with no information about medication or risk assessment. Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 & 10 Service users can feel confident that their needs are recorded in detailed care plans and they benefit from sensitive staff and management support, however, they may be placed at risk of harm through inadequate risk management and care review processes. EVIDENCE: Service users health, personal and social care needs are set out in detail in their care plans to enable staff to provide appropriate care on an individual basis. Where risks are being identified within the risk management process, guidance for staff to minimise risk is vague and could place service users at risk of harm. It was of further concern that care plans are not being updated to reflect changing needs which occur outside of the six monthly review, care plans seen did not show any evidence of monthly reviews which could have a negative impact on the care received by service users. Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 9 Service users’ medication is administered largely via a monitored dosage system. Practice was observed during breakfast when the team leader was giving out medication from the trolley in the dining room, service users are being placed at risk in that tablets were being given to service users who were then left without being seen to actually take the tablets, the risk was further highlighted by the discovery of a tablet which appeared to have been left from the day before. Service users benefit from the care provided by the dedicated and committed staff team, interaction observed was warm and friendly and care was provided in a way which respects and protects the dignity and privacy of service users. Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15 Service users benefit from flexible routines however, insufficient staff at key times have a negative impact on the service provided. EVIDENCE: Service user benefit from the flexible routines in the home, they are able to exercise choice in relation to routines of daily living. Informed support is available to them through good recording processes which include likes and dislikes and personal interests. Service users complained that there had been very little opportunity for outings from the home due to the lack of a minibus driver. Service users were not being provided with a good service at breakfast on the morning of the inspection, there were no care staff available to help with service until 9 am, the team leader was busy dealing with medication which left only one member of kitchen staff to serve breakfast, this resulted in long waiting times and some frustration. The majority of service users were not offered choice, cornflakes were served with milk and sugar already poured on in the kitchen. Care staff were busy getting up more dependant service users and were not available to help service users who required help with feeding until later. Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 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 examined at the previous inspection and were found to be met. EVIDENCE: Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Service users have benefited from improvements made since the last inspection however, their quality of life is adversely affected by failure to comply with previous requirements. EVIDENCE: Service users are benefiting from the improvements in the environment created by the rigorous programme of redecoration, which has been implemented, and all areas were clean and homely. It was confirmed that the environment will be further improved for service users by the replacement of the carpet in the dining room by more suitable flooring, some window frames have been replaced and others are being replaced shortly, along with paving in the garden. The quality of life for some service users is affected by the provision of furniture which is not fit for purpose in that some wardrobes are far too small and new bedroom chairs are not suitable for relaxing comfortably in, should Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 13 service users whish to spend time in their rooms rather than in the communal sitting areas. Telephone and television sockets are not provided and not all bedrooms have sufficient electrical sockets. Service users who share room are mainly those who have dementia, therefore, it is impossible to make a judgement that it is their positive choice to share. Those who share are also adversely affected by the inadequate size of these rooms, which are too small to accommodate the furniture required within the standard. Service users, particularly new admissions and those with dementia will find orientation within the home difficult as all the doors look alike and no adaptations have been made to assist service users with cognitive, visual or hearing impairment. Previous inspections have identified the need for specialist assessment of the premises by suitably qualified persons who would provide appropriate advice in relation to these issues but this has still not been done. Service users are protected from infection by laundry systems, which minimise the risk of cross infection as far as possible given the cramped conditions in the laundry. It was agreed that advice would be sought from the Environmental Health Officer to confirm that the current facilities remain adequate for the continued protection of service users, given the increasing demands on the laundry service. Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are 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 examined on this occasion. EVIDENCE: Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 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 majority of these standards were examined at the last inspection and were found to be met. EVIDENCE: Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 3 3 2 2 2 3 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x x Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? YES 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 19 Regulation 23 Requirement The corridor carpets on the first floor bedroom carpets and dining room carpet should be replaced as they are worn and stained Rotten window frames should be repaired/replaced. These requirements have been partially met 2 23 & 24 23(2)(n) Bedrooms must be furnished with at least the minimum requirements as set out in the standard or a risk assessment re individual’s bedroom furniture be in place, This remains outstanding from previous reports. 3 22 23(1)&(2) (a) An assessment of the premises and facilities should be made by suitably qualified persons, including a qualified occupational therapist, with specialist knowledge of the client groups catered for. Specific environmental adaptations should be made to assist service DS0000023955.V249441.R01.S.doc Timescale for action 31/10/05 31/10/05 31/10/05 Hevercourt Version 5.0 Page 18 users with sensory loss, dementia or other cognitive impairment. This remains outstanding from previous reports. 4 3 14 The registered person shall not provide accommodation to a service user unless the needs of the service user have been assessed by a suitable qualified or suitably trained person – in line with the admission procedures of the Trust. Care plans shall include risk assessments in relation to all identified risks with clear guidance for staff on how to minimise these risks. 31/10/05 5 7 13(4)(c) 31/10/05 6 9 13(2) The registered person shall make 31/10/05 arrangements for the safe administration of medicines in that medication should not be left with service users at dining tables without supervision or signed for before the team leader is certain that it has been taken. The registered person shall consult with service users about their social interests and make arrangements to enable them to engage in local, social and community activities in that opportunities for outings shall be arranged for those who wish to participate. There must be sufficient numbers of staff on duty to ensure that mealtimes are appropriately supervised with enough staff to serve service users without undue delay and DS0000023955.V249441.R01.S.doc 7 12 16(m) & (n) 31/10/05 8 15 16(2)(i)& 18(1)(a) 31/10/05 Hevercourt Version 5.0 Page 19 offer maximum choice and promote independence. 9 23 12 16(1) (2) 23(1)(2) The size and layout of rooms occupied by service users must be suitable for their needs i.e. shared rooms should sufficient space to accommodate the required furnishings and be occupied by service users who have made a positive choice to share. When a shared place becomes vacant, the remaining service user should be offered the opportunity not to share. Each person should have comfortable seating. 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hevercourt DS0000023955.V249441.R01.S.doc Version 5.0 Page 21 - 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!