Inspection on 08/01/07 for Homelands

This inspection was carried out on 8th January 2007.

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

Homelands 13/11/08

Homelands 05/10/05

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 Key Unannounced Inspection 8th January 2007 1:40 Homelands DS0000023446.V300658.R01.S.doc Version 5.2 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.V300658.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 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.V300658.R01.S.doc Version 5.2 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 Canterbury Oast Trust Victoria Anne Kerr Wardrope Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 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. A full time team of staff, 90 of whom hold NVQ or other relevant qualifications, support people each day. There are two sleep-in staff on duty throughout the night. Situated in a 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 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. Public transport is infrequent in Aldington, so the home has access to 3 vehicles. 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. Previous inspection reports are available from the home. The weekly fee for this service starts at £772.23. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key site visit took place on 8th January 2007 between 1.40pm and 5.30pm. The manager, Ms Vicky Wardrope, service users and staff assisted with the process. Eight people live at the home, and five gave some face-to-face feedback. Four service user comment cards were received before the site visit. People were coming and going in and out of the house on appointments and activities. The manager and a service user showed off some parts of the home. The inspection process consisted of information collected before and during the visit to the home. Other information seen included assessment and care plans, medication records, duty rota and employment paperwork. What the service does well: The home has a friendly, homely atmosphere. Service users are involved in many decision-making processes. People are involved in running their home People are getting out and about into the community a lot. There are lots of opportunities to meet new people and to have fun. Relationships (personal and with families) are supported, and people know that they can seek help from staff to see their friends. Personal interests are encouraged. Residents plan holidays to places that they really want to go to. Several people are fully involved in preparing meals. Everyone has unrestricted access to the kitchen. People are actively involved in staff recruitment. They are supported to learn how to use the complaints procedure. Five service user comment cards were returned, and all said they were happy living at house and liked the staff. Some comments said;‘I like my holidays, the discos, go-karting, the staff and my housemates’. ‘Its beautiful, I like living here’. ‘Like disco, parties, activities’. ‘I like who I live with, my house, furniture, going out with my friends, holidays. Four relative / care manager comment cards were returned, saying they were all very happy with service, and no problems were noted. Some comments were ‘Good service over recent years very consistent standard of care Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 6 provided’. ‘Excellent, well established staff team at Homelands who know the residents really 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. The summary of this inspection report can be made available in other formats on request. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 7 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.V300658.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Current service users aspirations and needs are assessed. EVIDENCE: There have been no new admissions to this home for many years. The admissions procedure was discussed, and the manager described that aspirations and needs would be carefully assessed. Existing service users have their needs and hopes for the future reviewed regularly. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual plans do reflect changing needs and goals, but it is not clear on how much say people are having. People are supported to make personal decisions wherever possible. Risk assessing promotes an independent lifestyle. EVIDENCE: Each person has an individual plan. These are informative and describe the support a person needs and state the individual goals. These are useful to staff to provide a continuity of support, but they have not been fully developed in consultation with the individual in question. Staff, who have in-depth knowledge about the person have written the support guidance. It is recommended that people are consulted about the way they wish to be supported. This should be written in a way the person understands and can keep track of, for example, person centred planning tools. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 10 By comparison, decision-making is really well supported. People are increasing their involvement in the home, the community and leisure time. Clear documentation shows pictures and symbols have been used (where needed) for this consultation. People are saying what they want from their lives, what they aspire to, and the manager and team are supporting them to get there. Choices people make that are not healthy, and therefore result in restrictions, are clearly documented. Advocacy and self-advocacy is being sought and promoted. Risk taking is also managed well, and restrictions are clearly explained and agreed with individuals. The manager sees that personal development will incur some risks, and so discusses how to reduce these with the individual and staff team. Financial risks are now minimised, and all service users sign to withdraw their own personal allowance from the bank. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users choose their own activities at home and within the community. Relationships are well supported. Rights and responsibility taking in all daily life activities is encouraged. Healthy meals are chosen and prepared by residents. EVIDENCE: The people living at the home choose their educational and occupational activities. Recent reviews have shown that people have done the same unpaid work experience for many years. Staff are supporting people to seek paid employment and experience different opportunities to broaden individual’s horizons. There is lots of focus on becoming more independent and potentially moving away from the benefits system. Inventive ways of encouraging local employers to consider employing individuals are being tried out. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 12 Although the home is situated in a rural place, there are 3 vehicles for use, so getting out and about in the community is a frequent event. Semiindependent travel using public transport is worked into journeys, and people said they enjoy using the train and paying for their ticket. Individuals are supported to see their families as they wish. Advocacy and self advocacy services are being sought for all residents. Close personal relationships are very well supported. Rights and responsibilities in daily living tasks have improved. Everyone is expected to contribute to running the home, and very clear jobs tasks in picture form were in place. One person proudly showed their housework list with photographs of them completing each task. They signed off their task as they completed it and understood what came next using this. They looked very pleased about using this system. Staff and service users get on very well, with no detectable hierarchy. Service users have keys to the house and their room. Each person is involved with meal preparation. All prepare their own breakfasts and packed lunches. Menus are now planned weekly, to give people more chance to say what they want. Staff help guide people to make healthy choices, but many service users are well educated in this area, and actively promote this. The kitchen is unrestricted and people can make drinks and snacks as they wish. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive discreet personal support. Physical and emotional health needs are well supported. Medication management is good and some service users are working towards self-administration. EVIDENCE: Feedback from service users said they are supported with respect and dignity in personal care. The guidance for staff on how to support people is clear, but it is not always the individual service user who has agreed what level of support they want. The manager is working on this. Physical and emotional health needs are being well supported. People know why they are seeing health care people. The manager always seeks service user permission before sharing personal information with others. Clear notes of outcomes are kept, and recommendations are followed. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 14 Medication management has developed; one service user is fully in control of their medication and two others taking on a much more active roll in administration. The manager hopes to have other people more involved over the next 12 months, taking the assessment and teaching approach. Medication administration records (MAR) are in very good order. The forms are being used, as designed, for all medication related purposes. This has reduced the number of forms to fill in and made records more clear. Staff have training and competency assessments on a semi-regular basis. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff listen to service users views and act upon them. Service users are encouraged to speak up and staff have training to recognise abusive practice. EVIDENCE: Service users are encouraged to speak up. The manager recognises that complaints could be hard to make, so has introduced the service users to the system. All have had a practice session using the complaints procedure and know what to expect from staff. All feedback indicated service users really do feel listened to. The manager says that the pictorial complaints policy and complaints prompt sheet needs improving and hopes to do this in the near future. Adult protection training is given to staff. There is no competency assessment to check that this knowledge is still fresh and being applied. This type of ongoing quality check is recommended. Staff have access to the manager and also have regular private supervisions and are encouraged to discuss concerns. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable, hygienic, safe and very homely. Most bedrooms are excellent, but two need size assessment. EVIDENCE: The home is an exceptional building with lots of communal space and character. Service user feedback was unanimous that they loved the house. It is well furnished and re-decoration has been or is being chosen by service users. People have full and unrestricted access to all parts of the house at all times. The gardens are safe and accessible and all the small, long outstanding maintenance jobs have now been completed. The service users support a domestic staff member to keep the home clean and hygienic. Most bedrooms are large and meet individuals needs. They are well furnished and reflect personal taste. One person fed back that their room is too small. There are two smaller rooms, and the manager is aware of the person’s Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 17 feelings. This is a long-term issue, and should be assessed. Future development plans should take this into account. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff have the right competencies and qualifications to support service users. They benefit from service user needs led training. Recruitment involves service users and follows the correct procedures to ensure service users are safe. EVIDENCE: Over 90 of the staff team hold an NVQ 2 or higher qualification. Service users say they like the staff very much and get on well. All service users went on holiday in 2006 supported by staff they got on well with. All service users have a key worker, but the manager promotes that all staff should form good relationships with every service user. Staff have benefited from training that reflects the needs of the service users. The manager requests the desired training from a central training coordinator, based on the service needs. Recruitment and selection fully involves the service users. The manager and team have worked with service users to devise questions they want to ask Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 19 prospective staff. The manager and a panel of residents interview prospective people. Simple, pictorial score sheets were used for comparison and for equal opportunities. All documentation (police checks, references) were in place prior to the staff commencing work. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and actively involves the service users. Service users know that their views make a difference in the home’s development. Health and safety is promoted and service users are protected. EVIDENCE: The manager has involved service users in all decisions made in their home. From recruitment to decoration, the emphasis has been to encourage and teach people to take more responsibility and enjoy being more in charge. The manager is just completing the NVQ 4 management and is about to start the Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 21 Registered Managers Award (RMA) component of this qualification. The manager receives some supervision from the area manager. Much of the development that has taken place has come from direct service user feedback. The staff and service users meetings have improved, and have resulted in things that are meaningful getting done. Service users are given the chance to say if the minutes are right, and these issues are taken to staff meetings as action points. Service users are asked to put issues for discussion on the staff meeting agenda too. The views of family are taken into account, but are balanced against the wishes and needs of the individuals. The home has a very good basis for a strong quality assurance system, but has yet to formalise this into something that can be continuously self monitored to measure progress against. But, at the moment, the outcome for service users is very good. Staff take a very active role promoting health and safety, and many service users are aware of their role in keeping the home and themselves safe. All certificates are up to date and the recent change in Fire Legislation is understood. The manager said the organisations health and safety representative has assisted the review of fire risk assessments. Staff health and safety training is up to date. Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 3 X X 3 X Homelands DS0000023446.V300658.R01.S.doc Version 5.2 Page 23 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 YA6 Regulation 15 Requirement Previous requirement with timescale 01/02/06 Standards 6, 18 Service users needs, support and personal goals are drawn up in consultation with them and presented in a way they understand. Timescale for action 01/06/07 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 2 Refer to Standard YA23 YA25 Good Practice Recommendations Staff have competency assessments in adult protection. Assess the suitability of the two small bedrooms. Future development plans should take the size into account. 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