Inspection on 06/09/05 for High Trees

This inspection was carried out on 6th 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. 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 13/12/05

High Trees 28/01/05

High Trees 16/11/04

High Trees 03/02/04

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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 Unannounced 6 September 2005 14:30 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 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 Stationary 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 H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service High Trees Address Lympne Place, Aldington Road, Lympne, Hythe, Kent, CT21 4PA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01303 260453 Home Farm Trust Mark Reay Care home only 4 Category(ies) of Learning Disability x 4 registration, with number of places High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: High Trees is registered as a Care Home for up to 4 adults with a learning disability. The Home Farm trust is the Registered Provider and the home is currently managed by Ms. M Isaacs. The Home is one of several units operated by The Home Farm Trust on the Lympne Place site. The others comprising; Seaview House; The Chapel House Annexe and The Beeches. The High Trees unit is a relatively new build, and provides specifically for Service Users who have autistic spectrum disorder. The Area Service manager is based on site in the administration block High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was undertaken on 6/9/05 at 2:30 pm. Three of the four resident service users were absent, on holiday with other staff or on home leave. The remaining service user chose to spend only a fleeting moment in the company of the inspector before returning to his activity in the company of a staff member. The inspector spoke with the Manager and a member of staff, viewed a number of records and parts of the premises. 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 H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 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 standard(s) 1,5 The documentation available to prospective service users generally addresses the requirements of the NMS. Further information is needed for the prospective service user and representatives to be clear about what the home provides and the terms and conditions relating to the care and accommodation offered EVIDENCE: A Statement of Purpose is in place and generally complies with the NMS. The manager reported that further work is being undertaken on documentation relating to the home. The Statement of Purpose will be presented in an easy read form and emphasise the individuality of the home and the service it provides. The service user guide will set out the fees and charges, what they cover and the cost of extras. This and the statement of terms and conditions of residence, which has still to be finalised and implemented, should indicate the policy and responsibility for thee repair or replacement of property damaged by service users. High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 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 standard(s) Not inspected EVIDENCE: High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 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 standard(s) 11,12,13,14,15,16 Staff indicated a good level of awareness of service user support needs. Opportunities for development, activities and social contacts appear well balanced and managed. There is an open and relaxed feel to the home. EVIDENCE: It was reported that the development of living skills is central to the daily programme of activity at the Home. Self help skills are encouraged and promoted in domestic and social activity. Service users are free to come and go within and outside the home subject only to risk assessed restrictions e.g. limited unsupervised access to the kitchen and a coded lock on the garden gate. The service users are supported to keep their own room keys and encouraged to undertake housework ‘chores’ according to a rota. Visitors are encouraged and welcomed without restriction and may be received in the resident’s own rooms if seating is provided or in the communal areas. Family contacts and home visits are facilitated where it is the service users wish. The opportunities for formal employment are limited by the individual needs and inclination of the current service users. High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 Page 10 The house has a full programme of activity, however the service users do not often go out as a group because of the nature of individual needs. All have the opportunity to go with staff 1-1to social and activity venues. As noted in the summary, service users are supported on individual holidays by two staff members at venues that can cater for their needs and are chosen, where possible by the individual. The home makes use of the local facilities and services as far as possible. These are however somewhat limited. The home has unmarked vehicles which are used to transport service users to various venues. The Trust locally endeavours to maintain a community presence by hosting and attending various functions High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 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 standard(s) 18,19,20 Service users receive personal support in accordance with their needs and their healthcare is promoted. The systems in place for the administration of medication have improved. EVIDENCE: The Manager reported that she and all support staff are well aware of the need to ensure that an individuals rights are not compromised by admission to the home and privacy is respected at all times The Manager confirmed that service users are helped to access community health services and accompanied as required. Specialist advice and information would be sought in respect of behavioural and health issues in the home. Visits to and from the GP are conducted in private. Requirements of a previous report relating to medication have been attended to. Excess stock has been returned; the ordering system is closely monitored; staff have completed medication training and are subject to a competency assessment before becoming involved in medication administration. High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 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 standard(s) 23 EVIDENCE: All staff have undertaken ‘physical intervention’ training. The manager reported that this is mainly for staff confidence as there is seldom a need to practice or apply the knowledge. All staff have attended ‘abuse awareness’ training and have access to the HFT policy and procedure. The manager needs however to ensure that she and staff are familiar with the local protection committee protocol. High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 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 standard(s) Not inspected EVIDENCE: High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32.33,34,36 Recruitment practices are in place to provide protection for the service users. Staff are offered training to help them work more effectively with the service users. The staff team is supported and supervised. EVIDENCE: Staff spoken to appeared to be clear about roles and responsibilities within the home and the care of the service users. She was provided with a job description and statement of terms and conditions of employment. General Social Care Council codes of conduct and practice are available to staff .The staff member spoke positively about her job, said she has good support from her manager and that training needs are discussed. She felt that the induction programme equipped her to perform her duties effectively. The Home has a complement of 12 full time staff (1 manager, 2 Senior support workers and 10 support workers).. The home endeavours to maintain a level of 3 support workers rostered per shift plus the manager who is supernumery. This reportedly allows for uninterrupted work with service users and the completion of catering and domestic tasks. A number of staff have skills and or experience of working with people with autism. Some have additional ‘specialisms’ ie communication. Additional specialist services are secured where necessary.. The manager indicated a good awareness of the need to ensure adequate checks are made on all potential staff to determine suitability and protect the High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 Page 15 service users. Company recruitment/induction and probation procedures are in place. The manager reported that staff are offered regular opportunity to attend statutory and service specific training. The Manager has extensive training and experience and has attained the NVQ level 4 in Care and management. High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected EVIDENCE: High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 Page 17 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 x x x 2 Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 High Trees Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 Page 18 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 of residence has still to be finalised and implemented Timescale for action Previously 31/3/05 amended to31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA1 Good Practice Recommendations The Statement of Purpose to be presented in an easy read form and emphasise the individuality of the home and the service it provides. The service user guide to set out the fees and charges, what they cover and the cost of extras. The manager needs to ensure that she and staff are familiar with the local protection committee protocol. 2. YA23 High Trees H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 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 H56-H05 S39200 High Trees V244329 060905 Stage 4.doc Version 1.40 Page 20 - 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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