Inspection on 26/03/08 for Hevercourt

This inspection was carried out on 26th March 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

Hevercourt 28/02/07

Hevercourt 24/01/06

Hevercourt 21/09/05

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 Christine Lawrence Unannounced Inspection 26 March 2008 10:00 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.V359358.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 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.V359358.R01.S.doc Version 5.2 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 www.kcht.org 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.V359358.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 February 2007 Brief Description of the Service: Kent Community Housing Trust (KCHT) is a non-profit making organization. It is one of 22 care homes owned and run by 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, which applies to Hevercourt, 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. Hevercourt is a large detached building in a residential area on the outskirts of Gravesend. There are 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. There are some local amenities close to the home and there is also a minibus available. There are extensive car parking facilities at Hevercourt and two safe enclosed gardens at the rear of the building. Fees range from £341 to £460 per week. Information about the home will be provided by KCHT on request. Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection visit was unannounced and started at 10.00 and finished at 16.15. We, that is the commission for social care inspection (CSCI) looked at various records in the home and also used information sent to us by the manager through her completion of the Annual Quality Assurance Assessment (AQAA). We received surveys from thirteen relatives, five members of staff and one care manager and information from these surveys is included in this report. Information from the previous inspection was also referred to. A tour of parts of the building was undertaken in the company of one of the senior members of staff. We observed staff interacting with residents and we spoke to staff on duty as well as the manager. We asked an ‘expert by experience’ to accompany us during this inspection. An ‘expert by experience’ is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. She chatted with residents and staff and made her own observations and her comments are also used for this report. What the service does well: What has improved since the last inspection? A programme of replacement of windows has been started. Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 6 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. Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 7 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.V359358.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home judges that it can meet their needs because it assesses their needs before they move in. EVIDENCE: The individual records for two newer residents were looked at. They contained detailed information relating to physical and social care needs covering all of the aspects identified in standard 3 of the national minimum standards. The manager, Chris Clarke informed us that she or the deputy will carry out assessments and she tries also to always involve a member of staff so the newly admitted resident will know someone when they arrive. A comment from a care manager who completed a survey was “…assessment involves all the multi disciplinary team as well as clients and relatives…” and the records reflected that information is noted from placing authorities when they are involved. We observed a new resident being greeted on arrival with his family. Staff were welcoming and responsive and there was already a file made up of Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 9 necessary information for staff. Of the thirteen surveys completed by relatives ten of them ticked ‘always’ in response to the question relating to the support and care being what they expected or agreed. Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from having an individual plan of care which identifies how their health and care needs are to be met. They are protected by the home’s procedures for dealing with medication and they can be confident that they will be treated with respect. EVIDENCE: We looked at eight care plans for this inspection. They contained detailed information about residents care needs and information for staff about how to meet these needs. The care plans are based on assessments undertaken prior to admission and information received from the placing authority and relatives, where appropriate. Those seen were up to date with the information they contained. The care plans have been compiled with the involvement of residents wherever possible. This is especially reflected in the wishes regarding routines such as times to get up or go to bed and what kind of night time checks individuals prefer. The care plans are very individual and person centred although they follow the same format. All five of the staff who Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 11 completed surveys answered ‘always’ to the question about being given up to date information about residents’ needs. There is also a handover between shifts and we observed the one that took place during the day we visited. Community nurses visit each day to provide planned nursing and to look at residents referred by the home. A nurse was visiting at the time of the inspection and she confirmed that the home would identify any concerns about residents and bring them to her attention. The care plans contain information about monitoring the condition of residents skin to make sure that any redness is brought to the attention of community nurses. Residents weight is monitored and the home uses the malnutrition universal screening tool to identify if there are any problems relating to unwanted weight gain or loss. Residents’ individual records reflected that health care professionals are involved as required. Medication is appropriately stored and recorded and only staff who have received training give out medication. There are policies and written procedures in place but the manager is going to use the Royal Pharmaceutical Society of Great Britain’s updated guidance to ensure that current policies are up to date. Residents will be assessed regarding their wish to manage their medication themselves. We observed residents being treated with courtesy at all times. Staff knocked before entering residents’ rooms and all personal care was provided discreetly. How a person wishes to be addressed is included in the care plan and staff use the name preferred. One member of staff said that it was very much the ethos of the home to treat people as individuals and to respect their privacy and maintain their dignity as much as possible. Comments from relatives’ surveys included “…make sure their clients are well-nourished and cared for…” “…care is shown differently to individual people, treating each person separately…” “…they are able to talk and interact with him in the way he likes…” “…they talk as friends and not just someone doing their job…” “…treats people individually…” “…everybody is treated in a caring way, no matter what…” “…concern for the individual…” “…staff have been very kind and understanding…”. The manager has acquired information about the Department of Health’s Dignity Challenge and will be looking to see if this might enhance what is already practiced at the home. Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their preferences will be identified and responded to and that they will be enabled to maintain contact with friends and family. Residents will be enabled and encouraged to make choices and they will benefit from healthy, well-presented food at a time and place to suit them. EVIDENCE: These standards were particularly looked by the ‘expert by experience’. She noted the following after talking to residents, a member of the activities staff and the care staff and making observations of residents and staff interactions:I spoke at length to one of the Activity organisers and was impressed by her enthusiasm and interest in all the residents. When I arrived she was selling chocolate and sweets in the dining area and noting for her accounts all that she sold, to be reimbursed at the end of the month from residents’ own money. One person purchased with their own money whilst I was there and I was told they still liked to keep control of what they spent. I was shown a large brochure of outings that could be planned during the year, using the large minibus, which holds up to three wheelchairs. This brochure was very Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 13 wide ranging with trips to gardens centres, historical places of interest e.g. Chatham Dockyard, Ightham Moat etc: the trips usually lasting 4 to 5 hours including lunch. There is a rota of residents’ trips in order that everyone has a visit. These trips occur once a month. There is a further minibus which takes up to 8 residents which is used for shopping and smaller outings, as well as to take residents to planned appointments e.g. hospital visit, GP surgery etc. There is a church service held at 6 weekly intervals which is nondenominational. Residents spoken to were quite happy and content with this. The activities also included regular visits from someone who played the piano; residents sing along, a quiz, bingo session and plans have been made for a sponsored walk around the home’s gardens for those who wished to. A regular relatives’ forum is held where relatives are able to contribute ideas for future activities. I spoke at some length to several of the residents about the home and all responses were positive. One person said that she looked forward to the activities, especially the singing and piano playing. I asked all of these residents if they chose to join in with the activities and they all told me they had favourite things they enjoyed and if they didn’t want to join, there was no pressure and they sat and chatted, dozed and watched the television. I spoke at some length to the cook, who showed me the menus for the next three weeks and informed me that these were regularly updated. The menu for the day was on a notice board at the entrance to the dining room with some photographs of the dishes on the menu. I was told that everyone had a choice of two main meals one being vegetarian, and two desserts. I did not see anyone being asked but believe this was because of the time I arrived and started to observe (10.30am), however, everyone at lunch time appeared happy and enjoying their meal. I asked two residents what the food was like and if they had favourite dishes. They both said they liked the food and were given a choice. The food was very well prepared and looked appetizing; the majority of the residents came into the dining room and sat where they wished. One or two residents preferred to sit in the lounge and have their meal and this was responded to. One resident was assisted to eat by a care assistant and this was gently done. Throughout my visit, drinks were available to everyone and staff were very observant of the residents’ needs. Residents’ preferences regarding routines, personal care and activities are noted in their care plans. Staff try to be as flexible and responsive as possible. For instance two residents were enjoying their breakfast at 10.30. There are no restrictions on visiting times and relatives who completed surveys described the home as ‘welcoming’. Examples were also noted of staff supporting residents in their contact with their relatives through writing letters or making phone calls. The manager informed us that residents are encouraged to be as independent as possible regarding their own finances until they need help or support. Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Complaints would be handled objectively and in keeping with the home’s appropriate procedures and residents/their representatives can be confident that any concerns will be listened to, taken seriously and responded to. Staff are aware of adult protection issues and there are systems in place which create an atmosphere for protecting residents from abuse. EVIDENCE: All five staff who completed surveys said they knew what to do if any complaint or concern was raised by a resident or relative. Relatives were also clear about who they should talk to if the were worried about anything. One relative said, “…however trivial it might be it is always sorted out that day or as soon as possible…” and another said “…Dad knows he can go into the manager’s office and discuss his care and something will be changed if needed…”. The home has an appropriate complaints procedure. All care staff have received training regarding adult abuse. Discussions with the manager reflected her understanding of her responsibilities with regard to the protection of vulnerable adults. The organization has policies and procedure in place, including disclosure of bad practice and abuse (whistle blowing). There are also policies relating to safeguarding residents’ finances and valuables. Some of these policies are dated more than two years ago and should be reviewed to ensure they are still relevant. Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a safe, well-maintained home which is homely, clean, comfortable, pleasant and hygienic. EVIDENCE: We looked round much of the building in the company of a senior member of staff. There were lots of examples of making things as home-like as possible. This is reflected in residents’ own rooms, which are personalized, and in areas such as the bathrooms where there are attractive, colourful curtains. There is a programme in place for redecoration and replacement of furniture and fittings. One person said that her relative had new things in her room. The window frames that need replacement are either already done or are planned for. The garden is very attractive and well kept. Some changes and improvements have been made and there is a plan to have a ‘potting shed’ facility. The home was clean throughout and smelt fresh. The laundry Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 16 facilities are satisfactory and all staff have received infection control training. Hand washing facilities include soap dispensers and paper towels and a new sluice was being fitted on the day of the inspection. Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by sufficient staff who are competent and trained. Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: A written rota is maintained and shows who is on duty at which times. Extra staff will be on duty if a need is identified. For instance there is now somebody to cover breakfast times. There is a team of housekeeping staff, cooks and kitchen assistants, as well as a gardener/maintenance person. Twenty six staff have achieved national vocational qualifications at level 2 or above and four are currently working towards this. Staff files seen show that the organization has thorough recruitment procedures which include seeking references, using an application form and formal interview, criminal record bureau checks and terms and conditions of employment. One member of staff said she wasn’t allowed to start work until all the checks had been carried out. There is a training programme in place which includes induction training, which is comprehensive. It covers mandatory training as well as other things relating to meeting the needs of residents such as risk assessments, mini bus driving, Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 18 dementia awareness and responding and managing difficult behaviour. The training programme for ancillary staff is also comprehensive. Staff said that the training they receive helps them to understand and meet the needs of residents. One person thought they would benefit from some training regarding race and ethnicity and although there are policies and procedures in place consideration should be given to providing diversity awareness training. Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from the home being managed by someone who is competent, experienced and knowledgeable. Residents’ financial interests are safeguarded and their views are sought. Staff and residents have their health and safety promoted and protected. EVIDENCE: The manager is experience and qualified. She has achieved both the national vocational qualification in care level 4 and the registered managers’ award. She has worked at the home for some years, working her way up to her present position. The training record shows that she undertakes other training in order to keep up to date. In discussion with us, while going through the Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 20 information in the AQAA, she demonstrated an awareness of the needs of older people, with and without dementia, and for their families. There are plans to improve the internal quality assurance audits within the home and the manager is also planning to introduce ‘Quality Circles’ to further improve how everyone is involved in looking at the care provided. The organization has Investors in People accreditation. Visits to the home by a representative of the organization, are undertaken in keeping with Regulation 26. The systems in place regarding the homes’ involvement with any aspect of residents’ money are robust. A spot check on maintenance and service certificates showed them to be appropriate and up to date and fire safety checks are carried out. Staff have received training with regard to health and safety. Hevercourt DS0000023955.V359358.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 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hevercourt DS0000023955.V359358.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 Hevercourt DS0000023955.V359358.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone 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. 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