Inspection on 23/07/08 for Homeleigh

This inspection was carried out on 23rd July 2008.

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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Homeleigh 10/08/07

Homeleigh 30/08/06

Homeleigh 04/10/05

Homeleigh 07/06/05

Homeleigh 04/11/04

Homeleigh 24/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOME ADULTS 18-65 Homeleigh Sondes Road Deal Kent CT14 7BW Lead Inspector Mark Hemmings Unannounced Inspection 23rd July 2008 09:00 Homeleigh DS0000023280.V367521.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 Homeleigh DS0000023280.V367521.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. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homeleigh Address Sondes Road Deal Kent CT14 7BW 01304 380040 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) Homeleigh Care Ltd Mr Dhunputh Seewooruttun Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16) of places Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The 4 residents with learning disabilities must also have mental health difficulty 10th August 2007 Date of last inspection Brief Description of the Service: Homeleigh (the Service) is registered to provide accommodation and personal care for 16 adults who have problems with their mental health. The premises are a detached house. Most of the bedrooms are on the first floor. When full, three of the bedrooms can be shared by two people each. All of the bedrooms have a private wash hand basin. On the ground floor, there are two good sized lounges. At the back of the house there is an enclosed patio garden. The Service is in a residential area that is within easy walking distance of Deal’s town centre. The seafront also is only a short walk away. People who might want to move in can get information from several sources. There is a Service Users’ Guide. This is a brochure that outlines the main things available in the Service. There is also a document called a Statement of Purpose. This gives a more detailed account than does the Guide. The Registered Provider ensures that a copy of the most recent Inspection Report from the Commission is available for people to read. The current fees for the service at the time of the visit range from £298.00 to £450.00 per week. The actual amount charged depends upon the source of funding used and the level of personal care required. The fees include all accommodation, meals, personal care, laundry and in-house entertainment. They do not cover things such as personal toiletries and hairdressing. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this Service is 2 Star. This means that the people who use this Service experience good quality outcomes. The commission since 1 April 2006, has developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 09.00 and was in the Service for about seven hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Registered Provider in its self-assessment. This is called the Annual Quality Assurance Assessment (AQAA). Further, it considered any information that the commission has received about the Service since the last inspection. This included questionnaires from ten of the people who live in the Service and from six members of staff. During the inspection visit, we looked at a selection of the records and documents kept in the Service. We spoke with the Manager, the deputy manager, the cook and four support workers. Also, we spoke with five of the people who live in the Service and spent time in the company of others. We examined parts of the accommodation and grounds. What the service does well: There is a relaxed and homely atmosphere. The people who live in the Service say that members of staff are kind and attentive. People say that they receive the support and assistance they need and that this is in line with their expectations. People are helped to maintain their health. Medicines are handled safely. People are served with good quality meals. There are opportunities for people to do things that interest them. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 6 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 Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 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 Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2 and 5. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People are asked about what support they need before they move in. Additional information is collected to fill out the picture. People are told what they can expect to receive and what will be expected of them. EVIDENCE: The Manager does an assessment of each prospective person’s needs for support. This is done before a decision is made about whether or not the Service is a suitable place for the person to live. The assessment is completed by talking with the person concerned. Other people are also involved. For example, family members, care managers (social workers) and community psychiatric nurses. The sort of information considered includes important things such as the person’s mental health needs, the presence of anything that might put them at risk and what the person likes to do each day. We spoke with some of the people who live in the Service about what it was like to move in. They say that the Manager spoke with them to find out what support they wanted to have. Also, they say that support workers knew about all of this Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 10 from the point they moved in so they felt that they did not have to go through it all again. Each person is told about what support and what facilities they can expect to find when they move in. Also, they are told about the sorts of things that will be expected of them. For example, the need to take into account other people’s needs as well as their own. There is a written account of all this information so that people can check it out if they forget something. The Manager says that this written information has recently been updated to make sure that it answers the most frequently asked questions. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 11 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): Standards 6, 7 and 9. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People get the support they need and want. They are helped to manage their money. Sensible steps are taken to help people stay safe. EVIDENCE: People say that the support workers offer them all the assistance they need. There is a written individual plan of care for each person. These are important because they are one of the way by which people can have a direct say in the support they will receive. Also, the plans are a source of information for support workers. This then helps them to provide support in a consistent manner. The Annual Quality Assurance Assessment recognises the importance of both of these aspects of the planning process. We looked at five sets of these plans. They contain a lot of useful information. For example, one person needs help to be up and about. Someone else tends to need help to not get stuck on something that then stops them getting on with other things. There is Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 12 also information about practical things such as the support that might be needed in the bathroom. The plans of support are reviewed to make sure that they are up to date. The people concerned are actively involved in this process. We asked four of the support workers about the support some of the people get. They know about this and can give and clearly have a detailed knowledge of each person’s needs and wishes. A doctor has said that two people can have a particular medicine as and when they need it. This is to help them when they are becoming anxious about something. The arrangements for giving this kind of medicine need to be thought through carefully. This is to make sure that it is used in a consistent way and that the people who take it know why it is being offered to them. We think that more work now needs to be done to make sure that both of these requirements are being met. The Manager says that this will be done by 1 September 2008. People are helped to manage their financial affairs. Some of them have their own bank accounts that support workers help them to operate. The others have their financial affairs managed on their behalf by family members or by councils. We think that with support more of them could do this for themselves. People are helped to manage their personal spending monies. Often this is done so that they do not spend too much money at once and then find themselves short for the rest of the week. We looked at some of the records of the various transactions made. We found things to be in order. The amounts spent are reasonable and the things bought are what you would expect. The cash balances match what the records say should be there. People are helped to not take unreasonable risks that might put themselves and other people in difficult situations. For example, people are asked not to smoke in their bedroom because this might be a fire hazard. Some people are accompanied when they go out. This is so that they are safe crossing the road and can enjoy being out without getting lost or going too far. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 13 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): Standards 11, 12, 13, 14, 15, 16 and 17. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People can do the things that interest them. They are helped to keep in touch with family and friends. People are helped to do their own catering. EVIDENCE: People are helped to do things for themselves and for other people. For example, they are encouraged to take care of their bedroom by making their bed and helping out with their laundry. They are also asked to do things around the house like everyone does. For example, helping out with some of the cleaning and doing some of the washing up. People are free to do things that interest them. For example, one person helps out in the office. Someone else likes to help support workers with the Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 14 shopping. The Annual Quality Assurance Assessment says that more emphasis is being put on this and some people now help the cook to do baking. There is an important balance to be had between people doing and being left alone. We think that this is about right in the Service. People say that the pace of their daily life is relaxed and unhurried. Within reason they can choose things such as when to get up, when to go to bed and what to do with their days. The Annual Quality Assurance Assessment emphasises the importance of recognising that some people can do more than others. This is reflected by support workers who respond to each person in an individual way. Most of the people leave the Service regularly either on their own or with a support worker to go the local shops or to venture further afield. We looked at the record of the things two people have done since 1 July 2008 to get a feel of how this all works out in practice. One of the people went out 13 times when they did things like shopping, going out for lunch and going to a local company’s open day. The other person who is less able to go out, still left the Service on four occasions. This included things such as walking to the nearby seafront. In the house, they did quite a lot of craft activity such as making jewellery. They also did beauty treatments such as having their nails done. People are assisted to keep in touch with members of their families, if it is their wish. Family members and friends are welcome to call to the Service. The staff in consultation with the person concerned, keep in touch with family members so that they know how things are going. One person has been helped to make contact again with a member of their family they have not seen for a long time. Support workers are now helping the person make the necessary arrangements so that they can visit their relative. People say that they have good meals and that they always have enough to eat. We looked at the menu. This provides people with a normal and varied diet. There is a choice for each meal time. However, there is no record of who has had what. Therefore, we cannot know how this choice arrangement is working out in practice. The Manager says that a record of who is having what each day will now be started. We spoke with the cook. She says that there are always enough supplies in the Service to enable her to work to the menu. We saw plenty of supplies of things such as dairy goods and vegetables. The kitchen does not have a grill. This is unusual and it means that people cannot have quite basic dishes such as cheese on toast. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 15 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): Standards 18, 19 and 20. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People are helped to support themselves. This includes using health care services and taking medication. EVIDENCE: People are assisted in ways that are right for them. Support workers are courteous in their manner and informal in their approach. People say that the support workers are approachable and that they can rely upon them to be there when they are needed. People are assisted to maintain their health. Support workers keep a tactful eye open so that a doctor can be seen promptly should there be a need. Since the last inspection, support workers have helped one person see their doctor who has advised that a particular diet needs to be followed. They have then supported this person to stick to the diet plan. Another person needs to have Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 16 some dental work done but they are not too keen on the idea. Support workers are trying to sort this out. This is so that the person can be reassured enough to enable the work to be done. At the moment, no one is managing their own medicines. The Manager says that people will be helped to do this when this is right for them. We think that some people might be able to do more that they are doing at the moment. The present arrangement is that support workers hold and dispense people’s medicines. We looked at how this is done. Medicines are checked when they are received into the Service to make sure that they are the right ones. They are stored securely and in an organised manner. There is a procedure that support workers follow to make sure that each person receives the right medicine at the right time. There is a record kept of each time a medicine is given. We looked at three sets of these records and we found them to have been completed correctly. We then checked two medicines in detail to see if the amount recorded as having been given matched the remaining stock. The amounts left were correct so the system is working okay. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 17 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): Standards 22 and 23. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. There is a mistake in the information contained in the complaints procedure. The wellbeing of the people who live in the Service is safeguarded. EVIDENCE: There is a written complaints procedure. This explains how someone can raise a concern. As a first step, it is often best for people to try to sort out concerns informally with the Registered Provider. However, as an alternative they can contact us direct. The procedure does not explain this clearly and it does not give our correct contact details. The Manager is going put this right by 1 September 2008. Since our last inspection, the Registered Provider has received a letter from someone who used to live in the Service quite a long time ago. The person has voiced some concerns about parts of the support they received. We are satisfied that the Registered Provider has considered the matters in question. We were able to look into some of the concerns while we were in the Service. We did not find anything to back up what has been said. The Annual Quality Assurance Assessment says that the Registered Provider is committed to making sure that people who live in the Service are kept safe. For example, by being protected from being bullied or from being taken Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 18 advantage of in some way. There is a written procedure that says what some one should do if they become concerned about someone’s wellbeing. We asked two support workers about their understanding of this issue. We also wanted to know what they would do if they were to become concerned about something. They have a good knowledge of the signs that should alert them to something not being right. Also, they know what action to take if this happens. None of them say that there is anything to worry them about how things are going. We understand that the Registered Provider wants all of the support workers to do training on this subject to make doubly sure that they know what to watch out for and what they can do. However, when we looked at the training records we found that two support workers did not do training on this last year and that this shortfall has not been corrected so far this year. We asked the people who live in the Service about their sense of wellbeing. They say that they feel completely safe living in Homeleigh. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 19 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): Standards 24, 29 and 30. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People live in a comfortable setting that has a lived-in feeling to it. The bathrooms and the toilets are rather bare. The fire safety procedure has not been reviewed recently. The kitchen is clean. The laundry is well equipped. EVIDENCE: Most areas of the accommodation are decorated and furnished to a homely standard. However, the bathrooms and toilets are rather bare. Little has been done to make them into comfortable spaces. Some of the light bulbs do not have shades and so they cast rather a harsh light. The building is fitted with an automatic fire detection system. This provides a high level of fire safety protection. The Registered Provider has prepared a fire risk assessment. This is necessary so that it can be sure that the system is Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 20 working in the way intended. The assessment is now several years old. We looked at it and it is not clear whether or not one of the improvements it recommended has been done. Also, when we last called to the Service we pointed out that more thought needs to be given to enabling the front door to be used as an evacuation route. There is nothing to show that this has been done. The Registered Provider needs to update the assessment making it clear what has been done to sort out anything that is outstanding. This new assessment then needs to be sent to the Kent Fire and Rescue Service by 1 September 2008. This is so that we know that everything is in order. The kitchen is clean and well organised. The local Department of Environmental Health looked at the kitchen last year. Its reports says that there is an “exemplary standard of presentation and cleanliness”. The cook has as a good knowledge of safe food hygiene practices. For example, she knows about the need to prepare some foods separately from others and about sensible things like washing your hands. She checks that the fridges and freezers are cold enough and she has a system to make sure that foods do not go past their use-by dates. Most of the people who live in the Service smoke quite a lot. At the moment, there is no indoor smoking facility and so people are having to smoke outside on the patio. The Registered Provider intends to put up a conservatory at the back of the building that will become an indoor area for smoking. This will need to be done in time for winter. Some of the people have difficulties with getting about. The help they need is described in their individual plans of support. The support workers know about this information. We saw one of the people concerned being helped in the right way. The laundry is equipped with a washing machine and a dryer. It is organised and clean. As we have already said, it is the support workers who do most of the laundry and this arrangement seems to work well. People say that they each have a good wardrobe of clothes. There are new regulations that have been introduced to ensure that used water does not leak back into the main pipe-work. The Registered Provider is going to check with the local water supply company to make sure that it complies with these provisions. This will be done by 1 October 2008. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 21 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): Standards 33, 34 and 35. People who use the Service experience adequate outcomes. This judgement has been made using available evidence including a visit to the Service. There are enough staff available. There are limited shortfalls in the recruitment system. Support workers know a lot about the special needs of people who have problems with their mental health. However, there are shortfalls in the training arrangements. EVIDENCE: There are at least three support workers on duty during the day and at times there are four or even five. At night, there are two support workers on the premises. There are housekeeping staff who do most of the cleaning and there is a cook. There is an on-call system. This means that someone senior can be contacted for advice out of office hours. The Registered Provider completes a number of security checks in relation to new support workers. This is done to ensure that they are trustworthy people Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 22 who are suitable to have unsupervised access to people who may be vulnerable. We looked at the records relating to a newly appointed support worker. Most of the required checks are in place including a satisfactory police clearance. However, for Support Worker A the employment history is not detailed enough for us to judge if all the necessary references have been obtained. From the information that is there, we know that two references are outstanding. For Support Worker B, the records show us that one reference has yet to be sought. New support workers receive introductory training before they work without direct supervision. We looked at the records of the introductory training provided recently for a new support worker. They received training in a number of relevant subjects such as fire safety and the Service’s communication systems. They also received information about the needs and wishes of the each of the people who live in the Service. After that, support workers are provided with ongoing training. This is designed to develop further their ability to provide a high quality residential care experience. The Registered Provider has identified a number of key courses that it thinks support workers need to attend. We looked at the records of who has done what training in 2007 and 2008. The Annual Quality Assurance Assessment says that all of the records in the Service are up to date. However, we found things about training to be muddled. It is not clear which of the courses are core ones that everyone is expected to attend and which are needed for particular people. There does not seem to be any system to pick up people who miss a course because for example they are on holiday when it is held. However, we worked through the records given to us both when we were in the Service and afterwards to see who has done which of the courses that we assume to be core ones. There is a significant pattern of gaps. For example, no one undertook training in health and safety in 2007 and six support workers have missed the training so far in 2008. Or again for food hygiene, none of the support workers did training in 2007 and so far in 2008 nine people have not done the training. Looking at helping people move about safely finds that one support worker did not do the training in 2007 and so far this year none of the support workers have done it. We asked about how training is delivered. Most of it is done by a representative of the Registered Provider who calls to the Service to do it inhouse. However, we cannot really get to the bottom of how this is planned. No one seems to know in detail what training will be delivered by the representative during the rest of this year. The Registered Provider needs to get this sorted out. The Manager says that five support workers have just completed extended training about the safe handling of medication. This training has been done by a specialist who has called to the Service over a period of weeks. The Manager says that this arrangement will be used again so that most support workers Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 23 can do training in how to assist people who have problems with their understanding. After this but still in 2008, further training will be given over a period of weeks in the main mental health diagnoses including conditions that can occur because someone has been drinking too much. Support workers are encouraged to study for a relevant National Vocational Qualification (NVQ). Of the nine support workers employed in the Service, four have got the qualification and two more are working towards it. This qualification is important because it is designed to develop their ability to support people in the right way and to a high standard. The Manager says that he intends to complete an organised review of the skills and knowledge of each support worker. This will be done using a list of subjects recommended by the Department of Health. It will make sure that each support worker knows what they need to in order to give people the assistance they need. Given what we have said about the training arrangements we think that this is a very good idea. We looked at the adequacy of some of the skills and knowledge of four of the support workers. They have a good knowledge of how to respond helpfully to people who have problems with their mental health. For example, they know how important it is to have realistic expectations about the things that people might be interested in doing. Also, they understand that some people need to have more space than do others. They organise the support they give accordingly. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 24 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): Standards 37, 39 and 42. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. In general the Service is well managed. The quality assurance system does not collect enough information. There is a shortfall in the health and safety arrangements. EVIDENCE: The Manager is registered with us. This means that we have looked at his plans for running Homeleigh and that we think that these are right for the people who live there. The Manager does not hold either of the formal qualifications that are recommended for someone in his position. The qualifications are designed to guide managers in setting up the necessary Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 25 systems to provide high quality residential care. He says that he hopes to complete one of the qualifications in the next twelve months. This is overdue and so he does need to keep to this new timescale. There are various systems used to promote good teamwork. These include handover meetings at the beginning and end of each shift. These are used to discuss how each person is doing so that everyone knows who needs to do what during the forthcoming shift. Also, there are staff meetings. These are held every couple of months or so. We asked support workers about the management of the Service in general and about communication in the staff team in particular. They say that they are well supported in their work. They like the fact that it is only a small staff team. They think that this helps them to organise their work in an effective but informal manner so that people reliably get the support they need. People are asked about how things are going for them. There are informal discussions that happen as part of day-to-day life. There are also house meetings held every couple of months. We looked at the records of the last meeting. Most of the people who live in the Service were there. The subjects covered include useful things such as people saying that they would like to help more around the house and what they might do. We asked two people about the meetings. They say that they feel completely free both in the meetings and outside of them to have their say about their home. About once a year people are asked to complete a questionnaire to give a more detailed account of how things are going. We looked at these. Nearly everyone had completed them and the general view expressed is positive. The consultation system does not really include support workers. Also, there is no organised system to tell contributors what is going to be done to respond to any suggested improvements. The Registered Provider is going to address these shortfalls. This will be done in time for the results to be notified to us in 2009, when the Registered Provider submits its next Annual Quality Assurance Assessment. Regular checks are completed to ensure that the Service’s fire safety equipment remains in good working order. This includes a weekly test of the fire alarm bells and periodic more detailed checks completed by a contractor. There are unannounced fire drills and staff receive extra training in fire safety. Two people are overdue for this training. The Manager says that he will see to this by 1 August 2008. The Manager also says that a new system will be introduced to double check that everyone knows how to use the Service’s fire safety procedure. This is important because the level of fire safety protection in the Service largely depends on the actions taken by staff. The Manager says that this will be done by 1 October 2008. We asked two support workers about things to do with fire safety. Both know how to correctly call the Kent Fire and Rescue Service and both know what steps can be taken to reduce the chance of there being a fire safety emergency in the first place. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 26 There are certificates to show that the electrical wiring installation and the gas appliances remain in good working order. There have not been any significant accidents in the Service since our last inspection. The Manager is aware of the need to review any that do occur. This is so that he can take steps to stop things happening again. The Registered Provider checks the building to make sure that there are no hazards that might cause someone to have an accident. The Manager says that this is done regularly. However, the records we saw are dated 2005. The Registered Provider needs to make sure these are up to date so that we can be sure that there are no significant hazards to be sorted out. We did not see anything in particular that causes us concern. Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 27 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 2 35 2 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 3 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA34 Regulation 19 Requirement The Registered Provider must ensure that there are suitable references for Support Workers A and B. The need to complete suitable security checks for support workers was noted in our last inspection report. It should have been done by 01/10/07. Timescale for action 01/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Homeleigh DS0000023280.V367521.R01.S.doc Version 5.2 Page 30 - 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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