Inspection on 13/12/05 for High Trees

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

High Trees 13/07/06

High Trees 06/09/05

High Trees 28/01/05

High Trees 16/11/04

High Trees 03/02/04

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Southfields

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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 High Trees Lympne Place Aldington Road Lympne Hythe Kent CT21 4PA Lead Inspector Geoff Senior Announced Inspection 13th December 2005 09:30 High Trees DS0000039200.V258187.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 High Trees DS0000039200.V258187.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. High Trees DS0000039200.V258187.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service High Trees Address 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) Lympne Place Aldington Road Lympne Hythe Kent CT21 4PA 01303 260453 Home Farm Trust Miss Melony Isaac Care Home 4 Category(ies) of Learning disability (4) registration, with number of places High Trees DS0000039200.V258187.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: High Trees is a care home registered to accommodate up to four service users with a learning disability. Home Farm trust is the Registered Provider. The home is managed by Ms. M Isaacs. The home is one of several units operated on the Lympne Place site by the Trust. High Trees currently provides for an all male client group with autism. High Trees DS0000039200.V258187.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection visit undertaken on the 13th Dec 2005. The inspector spoke with the Manager and a member of staff and viewed a number of records. He observed staff and service user interaction and made an accompanied tour of the premises and garden. 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. High Trees DS0000039200.V258187.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 High Trees DS0000039200.V258187.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): 2,3,4. Trial visits, assessments of need and information gathering ensure that informed choices and decisions are made regarding admission to High Trees EVIDENCE: There have been no admissions to the home since the last inspection visit. The Inspector was informed that there has been no change to the previously reported admission process. All prospective service user contact is initiated via the HFT Social Worker who, together with staff from the home, undertakes a pre placement assessment and compiles a profile of needs. A visit to the client in his home and/or school environment prior to placement, the current care plan and care management input is taken into account in order to ensure that HFT can continue to appropriately meet his needs. Family and service user involvement is encouraged in the decision making process. The admission may be as protracted as necessary according to individual need. Prospective service users are offered the opportunity visit prior to admission, to meet and spend time with existing residents and staff and discuss the routine and lifestyle they could expect to experience at High Trees. It was acknowledged however that this may prove too unsettling to some service users and trial visits are only offered if appropriate. The home does not take emergency admissions. All staff have experience in working with adults with a learning disability and further training is offered, specifically autism awareness. A copy of the revised statement of purpose has yet to be forwarded to the commission. High Trees DS0000039200.V258187.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): 6-10 Service user plans identify the needs of the individual service users. Service users are enabled to make decisions affecting their daily lives. Risks are assessed positively and comprehensively. EVIDENCE: The home has developed well-structured, informative service user files. The needs of the individual are clearly identified as well as the actions required by staff to support clients. There is a key worker system in place. The introduction of Person centred planning has required the inclusion and involvement of service users to make it work. The stated intention is to emphasise choice as a matter of course in all issues relating to the support and care of the service users. It would appear from conversation with staff and observations made during the inspection that routine but not ritual remains one of the aims. Risk assessments are undertaken and recorded for all areas of risk relating to the environment, the house, day activities and external to the site. Action is identified to support service users in areas of greater need. The home maintains a staff level of three per shift plus the manager during the day in order to monitor and reduce risk and offer the opportunity for more activities. It was considered necessary to limit unsupervised access to the main site and to that end the garden gate is fitted with a baffle lock. Issues relating to High Trees DS0000039200.V258187.R01.S.doc Version 5.0 Page 9 confidentiality are addressed during the induction period. All records may be stored in a lockable office with staff access according to need and pertinence to duties.. There was no public display of confidential or personal information High Trees DS0000039200.V258187.R01.S.doc Version 5.0 Page 10 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): 17 Service users are encouraged and supported to become involved in the choice of menu, purchase of provisions and food preparation. EVIDENCE: Service users are involved in devising the menu plan and accompanying staff in shopping for provisions. Staff prepare meals with assistance from service users. (one at a time only in the kitchen).Breakfast is taken individually as service users choose when to get up, all sit together for the midday meal. Special dietary needs are documented and support guidelines written and available to staff. High Trees DS0000039200.V258187.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): Not assessed at this visit EVIDENCE: High Trees DS0000039200.V258187.R01.S.doc Version 5.0 Page 12 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): 22,23. EVIDENCE: Written information is made available to staff and to the service users and their family/representatives prior to and following admission. It details the company complaints policy. Service users are also helped to understand how to make a complaint in information available to them in an alternative format. The local Adult Protection Committee protocol has been obtained and is available to staff. All staff have attended in-house adult protection awareness training. High Trees DS0000039200.V258187.R01.S.doc Version 5.0 Page 13 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): 24-30 The home is clean and bright and appears to be adequately maintained. The layout and décor of the communal and private spaces reflect the needs of the service users. EVIDENCE: High Trees was purpose built on the HFT site with a specific client group in mind. It provides a spacious, light and airy environment in which to live and work. There is adequate private and communal space for the service users and appropriate facilities for the staff. At the time of inspection the home appeared to be clean, tidy and free from undue odours. The manager confirmed that systems are in place to ensure regular safety and maintenance checks are undertaken. Each service user has their own bedroom that may be furnished and decorated according to individual taste, preference and need. Externally there is an enclosed garden. Service users are discouraged from venturing beyond its boundaries without supervision. The manager informed the inspector of plans to purchase leisure equipment and furniture to develop a more stimulating environment. High Trees DS0000039200.V258187.R01.S.doc Version 5.0 Page 14 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): 35 Staff are offered training to enable them to more adequately meet the needs of the individual service users and improve the function of the home. EVIDENCE: Staff’s training needs are discussed at monthly supervision sessions. There is a rolling annual programme of statutory and NVQ enrolment and training. 75 of staff have NVQ level 2 .All staff are undertaking Makaton training and the use of symbols to aid communication. HFT will support staff in areas of particular interest and appropriate study paths. High Trees DS0000039200.V258187.R01.S.doc Version 5.0 Page 15 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): 37-43 The home is well run in a manner that is inclusive, supportive and encourages the development of clients. There are regular quality assurance and safety checks to ensure that the home is run in the best interests of the clients and their safety and welfare is protected and promoted. EVIDENCE: The Manager appears to be an experienced and well informed individual who endeavours to ensure that service users are consulted as appropriate. She has completed the Registered Managers Award/ NVQ level 4. It appeared from conversation with staff and from observation that the manager has established an approachable, open and supportive regime for staff and service users within a friendly relaxed atmosphere It was reported that a representative of the providers undertakes Regulation 26 visits at appropriate intervals. The site maintenance staff undertake weekly and monthly safety checks. High Trees DS0000039200.V258187.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 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 2 3 3 3 2 Standard No 22 23 Score 3 3 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 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 High Trees Score X X X x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000039200.V258187.R01.S.doc Version 5.0 Page 17 yes 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 YA5 Regulation 5 Requirement The statement of terms and conditions has yet to be finalised and implemented. Previously required by 31/12/05 Timescale for action 31/03/06 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 YA1 Good Practice Recommendations The amended Statement of purpose has yet to be forwarded to the commission. High Trees DS0000039200.V258187.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 High Trees DS0000039200.V258187.R01.S.doc Version 5.0 Page 19 - 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. 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