Inspection on 05/10/05 for Homelands

This inspection was carried out on 5th October 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Homelands 13/11/08

Homelands 08/01/07

Homelands 11/07/05

Homelands 22/02/05

Homelands 05/08/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Homelands Homelands Forge Hill Aldington Ashford Kent TN25 7DT Lead Inspector Lois Tozer Unannounced Inspection 14:25 5 October 2005 th Homelands DS0000023446.V256454.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 Homelands DS0000023446.V256454.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. Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Homelands 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) Homelands Forge Hill Aldington Ashford Kent TN25 7DT 01233 721229 01233 721229 Canterbury Oast Trust Vacant Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 2005 Brief Description of the Service: Homelands is registered to provide accommodation, personal care and support to eight people who have a learning disability, but are physically able. The premises is a listed 17th Century house which is approximately 15 minutes walk from the village shop and 10 minutes from the local pub. It is owned and operated by The Canterbury Oast Trust (C.O.T.), a charitable organisation and is managed by Ms Victoria Wardrope. Situated in an attractive rural location overlooking Romney Marsh, the house has many interesting features, and is extremely attractive inside and out. Communal facilities include a poolroom, spacious dining and lounge areas, and a large garden with a recently laid patio. The kitchen and laundry facilities are fully accessible. All bedrooms are registered for single occupancy. Staff have their own dedicated sleep-in facilities and office area. Access into the wider community relies on the homes transport (the public bus service being reported as infrequent). There is currently one dedicated vehicle for communal use, a second communal vehicle will be supplied during 2005. A woodland management project operated by C.O.T. is situated nearby; this is used for service user work experience and recreational use and is also open to the public. Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection took place on 5th October 2005 between 2.25pm and 4.45pm. The manager was not present during the inspection, but staff and residents were welcoming and very helpful, assisting the process happily throughout the visit – with thanks. Eight people live at Homelands, all for a number of years. Five residents spoke to the inspector, three gave lots of feedback at length and were very keen to say how much they enjoyed living at Homelands. All staff on duty gave input, and two gave feedback that is included in this report. During this inspection a range of evidence collection methods were used, these being; conversations with service users & staff; reading of care, support and goal plans and risk assessments; general observation and of activities taking place; documentation medication; a tour of the communal and external parts of the house and some residents personal bedrooms. Comments from residents included,- ‘We enjoy college, and go twice a week’. ‘I do cooking at college, and take turns to help staff with dinner’. ‘We like to go to the pub together, staff drop us off’. ‘I make my own lunch sometimes, today [named resident] did it with staff helping’. ‘All but one of us went to the Isle of Wight on holiday, it was great!! [Resident] who stayed behind when out to France for the day and did [their own] things’. ‘We did lots on the I.O.W., zoo, rides about, went to Needles, pubs, meals out, swimming – I enjoyed the whole week’. ‘College tonight, art [and cooking for me] – yes, it’s a good course and I enjoy it’. Staff were encouraging residents to complete their chores for house day, and did so in an encouraging manner, which was readily accepted by the resident. One resident said that staff do a lot of the communal cleaning and chores, and when asked, said residents could ‘probably help more, I suppose’. Residents were able name staff they would turn to if they had a complaint or problem, and all said they knew staff would help. Non verbal communication in Makaton took place, and all comments were positive in relation to life at the home. What the service does well: There is a wide range of planned activities available and the range of choice for activities outside of the home is extensive and well supported both financially and by staff availability. Residents are supported to go supermarket and local shopping each week and have input to what goes onto the menu, the frequency of writing this has changed to weekly, to enable more input by individuals. Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 6 A group holiday has taken place, and was really enjoyed (see above comments). Individual interests are well catered to and staff have good relationships with residents, enabling them to safely share problems or concerns. Staff benefit from Adult Protection (abuse) training and were clear on what to do in a situation of concern. The physical environment is safe and well maintained and gives residents a great level of freedom, to visit friends in nearby houses and to see other people regularly when they visit the woodland management scheme next door. What has improved since the last inspection? What they could do better: The manager has started the ball rolling in changing the staff role from ‘caregiver’ to ‘supporter’. This progress needs to be kept live, and be monitored continually, to ensure that staff achieve the aim of providing residents with a high level of supported independence wherever possible. The requirement to develop the individual plans, with a focus on individual development through goal and opportunity planning is a work in progress; the timescale for completion has been extended. The most important requirement to be addressed from this and the last inspection is the access to resident’s individual bank accounts. Currently in place are ‘chip & pin’ cards –the managers risk assessment has highlighted that this is not an acceptable method of money management for most of the residents. A safer method of accessing money from bank accounts is required. Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 7 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. Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 8 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 Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 9 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): On this occasion, none of these standards were inspected. EVIDENCE: Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 10 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, 7, 8, 9, 10 The requirement to review and improve individual plans has been extended, but work towards improvement is taking place. Residents felt included in decision making, records showed that participation had increased. Risk (actual and potential) is generally well managed, to increase individual independence; however regarding access to finances, risk remains unresolved. Records are securely stored. EVIDENCE: Changes to individual plans to really reflect each person’s needs and personal goals are planned. Consultation work is taking place, so the deadline for this requirement has been extended. Work has taken place to increase the level of involvement each person has with general day-to-day chores in the home, such as meal preparation and looking after the communal areas. Two residents said that they do have lots of chances to get involved in decision making, through meetings and by speaking to key workers and the manager. Risk assessments are in place to increase involvement and skills development in areas such as administration of medication. In discussion with the manager, risk assessments were written up to assess financial access via ‘chip & pin’ cards. The risk remains high, but the situation remains unresolved. The manager is urged to pursue this matter and find a safer solution. All records are stored securely. Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 11 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): 11, 12, 13, 14, 15, 16, 17 Resident’s opportunities to practice and develop skills, and therefore have rights and responsibilities recognised, has improved. Activities are meaningful and appropriate, and are chosen by each individual. Community presence is well supported, and many leisure opportunities occur in communal facilities. Relationships are well supported. Resident’s are fully involved in menu planning, and staff assist to ensure healthy choices are featured regularly. EVIDENCE: The residents said that they have more encouragement to make their own snacks and lunches, and do some of the housework. One resident said that ‘We could do more, I suppose’! Records indicated that participation had increased, but continual monitoring is needed to ensure that a new culture of support, rather than ‘provision’ is maintained. A staff member was encouraging a resident to get involved in cleaning tasks during the visit. Leisure activities are very well supported, and four residents said what a great holiday they had recently, on the Isle of Wight. One person had a different type of holiday, when asked, smiled broadly and said ‘Yes’, they had enjoyed themselves. Menu planning has altered, so pairs of residents plan for the forthcoming week, which increases the level of resident involvement. A staff member was concerned that healthy choices were not always being made, but Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 12 sensible sized portions and exercise is a clear feature of the home. Education and suggestions by the staff to the residents may increase individual awareness and enjoyment of healthier options, although, from records seen, menus did appear well balanced. Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 13 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): 19, 20 Each individual has access to a range of health care professionals; all health care needs are addressed swiftly. Records supporting medication management were clear and accurate; residents are becoming more involved in their own administration. EVIDENCE: Records as well as discussion with staff and residents showed that health needs are followed up swiftly with appropriate action being taken. A desensitisation programme is being considered, aiding an individual access to the optician. Medication records were in good order, and a risk assessed programme is in place to enable some residents to take greater control in administering their own medication. Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 14 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 Residents know who to raise concerns with and feel that they are listened to. Staff have received adult protection training and are aware of whistle blowing procedures, but individual financial management is still an area of heightened risk. EVIDENCE: All residents said that they would turn to staff with problems, and would speak to the manager if they needed to share a concern – although they felt the staff were ‘the best’ and would help them out. Staff were able to say how they would act if they witnessed abuse, and were aware of the whistle blowing procedures. Resident’s finances remains an area of concern, with the very vulnerable situation of chip & pin numbers being known to more than just the card holder. The risk assessment has highlighted that this practice needs addressing, and as in standard 9, the manager is urged to find a suitable resolution as soon as possible. Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 15 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, 25, 26, 27, 28, 29, 30 The home is comfortable and homely, and is to the residents liking. Bedrooms are personalised and there are sufficient baths and toilets throughout the home. Communal areas are extensive and the home is hygienic, but homely, throughout. EVIDENCE: All work identified as required previously has been, or is currently being, undertaken. The house has benefited from extensive external maintenance, and looks well cared for and sound for winter. Hot water is now supplied to the WC hand washbasin in the boot room. The whole home is comfortable, bright and to residents liking. Each person has their room furnished and decorated the way they want it. Shared space is extensive, and new furniture has been chosen by the residents, and is on order. The house is very homely, clean, and hygienic; a new, bigger, washing machine is soon to be installed. Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): On this occasion, none of these standards were inspected. EVIDENCE: Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 Regular checks to ensure everyone’s health and safety take place. EVIDENCE: Service certificates, per July 2005 pre-inspection questionnaire, are up to date. Regular environmental checks take place and action to sort out problems is swift. Residents feel safe and know that they are responsible for keeping the house safe too. Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 18 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 X X X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 4 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Homelands Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000023446.V256454.R01.S.doc Version 5.0 Page 19 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 YA6YA18 Regulation 12 (3, 4) 14; 15 Requirement Timescale for action 01/02/06 2 YA9YA23 3 YA35 4 YA39 Service user plan is to be written in consultation with the individual & presented in an understandable format. Must identify the strengths & needs and show what support will be put in place to promote greater independence and maintain skills (timescale extended from 01/10/05) 13 (4,b) From the risk assessment re 01/01/06 service user access to money using the ‘chip & pin’ facility, take action to make access safer. 17 (2) (Previous requirement, 01/01/06 18 (1,a,c) timescale extended from 01/04/04). Staff to receive structured induction and foundation training within a LDAF type framework. 12(5)15(1- (Previous recommendation) 01/01/06 2)24(1-3) Quality assurance survey for service users; ascertain, through the panel meetings what is really important to the service users themselves and measure this as well as the promises made in the statement of purpose & service users guide. DS0000023446.V256454.R01.S.doc Version 5.0 Homelands Page 20 Present in an easy to understand way. Seek information from learning disability focused research institutes such as B.I.L.D; Sector Skills Council (TOPSS) through L.D.A.F. & other forums. Develop Q.A. survey for parents & significant people in the service users lives. Publish outcomes in a useable format to work towards improvement & development. 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 YA9 Good Practice Recommendations (Previous recommendation) Risk assessments pertaining to service users are salient and to the point and reflect the benefit of an activity or risk situation and, where appropriate, have been done in consultation with the persons they apply to. Training to include active support skills, equal opportunities, support, goal, and shift planning. 2 YA35 Homelands DS0000023446.V256454.R01.S.doc Version 5.0 Page 21 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. 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