Inspection on 04/10/05 for Homeleigh

This inspection was carried out on 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found 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 23/07/08

Homeleigh 10/08/07

Homeleigh 30/08/06

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 09/07/2008.

CARE HOME ADULTS 18-65 Homeleigh Sondes Road Deal Kent CT14 7BW Lead Inspector Joseph Harris Announced 04/10/05 at 10:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Homeleigh Address Sondes Road, Deal Kent, CT14 7BW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01304 380040 Homeleigh Care Limited Mr Dhunputh Seewooruttun Registered Care Home 16 Category(ies) of Mental Disability registration, with number of places Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 07/06/05 Brief Description of the Service: Homeleigh is a residential home for people with enduring mental health problems situated in the seaside town of Deal. The home is registered for up to 16 people between the ages of 18-65. The service is set out over two floors, with a small number of bedrooms on the ground floor and the remainder on the first floor. The home benefits from a good level of communal space with a large lounge and an ample dining room. There is also a designated smoking room. A secure courtyard garden is located to the rear of the building. There are adequate kitchen and laundry facilities. The service has a relatively small, but stable staff team, many of whom have worked in the home for a number of years. The house is located very close to Deal town centre and within view of the sea. There are relatively good public transport links nearby and the town is well equipped with public facilities such as a library, cafes, sport centre, cinema and theatre. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 4th October 2005. This visit commenced at 9.30am and finished at 4.30pm. During the inspection discussions were held with service users, staff, the registered manager and the responsible individual. A tour of the premises was undertaken and a wide range of documents were viewed including service user plans, training information, health and safety information and other records relating to the service. What the service does well: What has improved since the last inspection? The home has made significant improvements over the past 18 months, which have continued at pace since the last inspection around 6 months ago. The changes have been wide ranging and are a testament to all involved in the home. Perhaps the most important advance is in the culture of the home. A positive and progressive outlook has been injected into the service promoting a collaborative approach to management and a desire within the team to raise standards. Care plans and risk assessments have been redeveloped and now provide good information in an accessible and logical format. The providers have invested in staff training and development providing TOPSS training videos and updating training needs. Staff are also well supported through Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 6 supervision and team meetings. The responsible individual also continues to update the environment, which is an on-going process, but evidence of progress is clear. Quality assurance systems are improved ensuring accountability. Staff are also working towards National Vocational Qualifications. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 4 and 5. Prospective service user’s needs are assessed and they have the opportunity to visit the home prior to admission. An adequate contract is provided. EVIDENCE: At the point of referral to the home the registered manager and staff ensure that adequate information is provided regarding the prospective service user. Evidence was available showing that recent referrals had only been admitted following adequate assessment processes. Copies of Care Programme Approach care plans and assessments were on file as well as other relevant background history. The home has developed a satisfactory assessment tool covering areas of need that is routinely completed for all residents. Prospective service users are given the opportunity to visit the home before deciding whether to move in. This can be provided on a flexible basis with day visits and overnight stays as required. An updated statement of terms and conditions of residence is provided on admission covering all key areas. A copy of this is given to the service user and/or their representative. A signed copy is kept with the home records. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 9 and 10. The home develops an individual plan based on need. Risks are adequately assessed. Records are kept confidentially. EVIDENCE: The staff in the home have worked hard to update the care planning systems to a good standard. The format has been completely revised since the last inspection and now provides good detail regarding assessed needs. The plans provide reasonable guidance to enable care staff to work consistently with service users, although this could still be expanded upon. The home has introduced improved systems to review the plans. Where possible, the home involves individual service users in developing the plan of care. Staff in the home are being encouraged to take a more proactive role in assessing and identifying needs. The systems for managing risks have also been reviewed and improved. Perceived risks are identified and a risk management plan put in place. The risk assessments identify actions to minimise the risks in adequate detail, although there is room to provide greater detail. The home reviews these plans on a regular basis and any restrictions imposed as a result of these plans are discussed with the service user and/or multi-disciplinary team. There is a missing persons procedure in place. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 10 Staff ensure that records are kept confidentially and in accordance with the Data Protection Act 1998. There is an access to records policy enabling service users to view the records held regarding them. Staff in the home understood the importance of maintaining confidentiality. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 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 standard(s) 11, 13, 14, 15 and 16. There are opportunities for personal development and to take part in the local community. The home has improved the range of leisure activities available. Service users are encouraged to establish and maintain relationships. Resident’s rights are respected. EVIDENCE: The home does provide some opportunities for service users to increase their levels of independence and daily living skills. This is generally addressed on an informal basis aiding residents to develop skills such as budgeting, community access and travelling on public transport. It would be beneficial to include life skills training within the service user plans to ensure a consistent and measured approach. Refer to recommendation 1. All of the service users enjoy and access local community facilities and resources. The home is ideally situated very close to the town and seafront of Deal. Staff are available to support residents in the community should they require this. A number of service users pair up to go to the library or other amenities. Many residents prefer going out alone and are encouraged to do so. All staff live locally and have an excellent knowledge of the area and resources Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 12 available. There are good transport links out of the town with a bus and train station nearby. The home has invested much time and effort into improving the range of activities available for service users should they wish to take part. One of the staff has taken on responsibility for organising activities and outings. Many trips were arranged over the spring and summer months to local places of interest. More in-house activities have been arranged including the regular bingo sessions, visiting entertainers and seasonal events and celebrations amongst other things. Key worker staff are also being encouraged to spend more 1:1 time with residents focussing on individual needs rather than simply those of the home in general. The home enables residents to establish new relationships and maintain existing ones. Relatives and visitors are welcomed into the home at any reasonable times. The staff are welcoming and friendly and maintain good communication with significant others. Residents stated that they feel respected and that their rights are upheld. “The staff treat me well” and “they (staff members) help me a lot” were some of the typical comments made. There is a supportive an open atmosphere in the home and staff look to assist only where necessary allowing personal choices and freedom. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 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 standard(s) 18, 20 and 21. Service users receive appropriate support. Medication systems and procedures are adequate. Rights are respected in illness and death. EVIDENCE: The majority of service users require only encouragement and minimal support regarding their personal care. Those that require higher levels of assistance do so in a dignified manner ensuring privacy. Guidelines and preferences relating to personal support are documented and regularly reviewed. Times for getting up and going to bed, etc are left to personal choice unless an assessed need is identified. Any specialist support required is provided in conjunction with the relevant healthcare professionals. The home receives a reasonable level of support from the local community mental health services. The medication is managed well within the home. There are adequate policies and procedures and storage facilities in place. The home’s administration records are clear, well maintained and up to date. None of the service users are assessed as able to self-medicate, although this could be an area of development for the service in the future. Any controlled drugs in use are stored and recorded appropriately. Staff who administer medication are provided with adequate training in this respect. Service users wishes with regard to ageing, illness and death are respected. Where possible the home documents any relevant information and preferences and enables residents to remain as long as possible in their home, ensuring Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 14 needs can continue to be met. A number of the service users are now over the age of 65 and a variation to the registration to enable these individuals to continue living the home needs to be completed, which was discussed with the responsible individual and registered manager. Refer to requirement 1. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected. Refer to unannounced report of 7th June 2005. EVIDENCE: Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26 and 30. The service users live in a comfortable and safe environment. Bedrooms are adequate for the needs of the service users. The home is clean and hygienic. EVIDENCE: The home is adequate for its stated purpose. There is sufficient living and communal space for the service users. The house is well situated close to local amenities and is accessible to all the residents. Furnishing and fittings are of reasonably good quality and the home is bright and well ventilated. The premises meet the requirements of the local fire and environmental health departments. The home recently commissioned an occupational therapy report ensuring that the environment is safe and suitable for the service user’s requirements. There is evidence of on going renewal and redecoration. All bedrooms are of an adequate size. There are three double rooms and the home needs to ensure that residents sharing rooms make a positive choice to do so. There is adequate provision of privacy in each of the rooms. Individual spaces are sufficiently furnished and residents can personalise their rooms if they wish. Some rooms still have linoleum/vinyl floor coverings, which should be appropriately carpeted. Refer to recommendation 2. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 17 During the visit the home was seen to be clean and hygienic, with adequate laundry facilities meeting all relevant specifications. Hazardous substances were safely stored and the kitchen and communal areas well maintained. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 35. The service is working positively to assist staff to gain National Vocational Qualifications. There are adequate numbers of staff on duty during the day and at night time. Staff training and development continues to improve. EVIDENCE: The home benefits from an experienced and stable staff team. The majority of the staff have worked in the home for many years and have developed good relationships with the service users. To their credit many of these staff have taken on the challenge of working towards and completing NVQs. 5 staff members have now achieved NVQ level 2 and two more are due to commence NVQ level 3 in January 2006. Domestics will also have the opportunity to achieve NVQ level 1 in cleaning and domestic services. There are sufficient numbers of staff on duty with a minimum of 3 staff during the day and 1 waking and 1 sleep-in staff member at night. Some staff have returned from sick leave and the pressure of hours on individual staff is less evident. The responsible individual confirmed that he is monitoring staff working conditions on a continual basis and will consider further recruitment. The service is continuing to improve and invest in staff training. The responsible individual has recently purchased TOPSS training videos, to be shared between two services, covering Adult Protection, fire safety, food hygiene and other topics for induction and refresher purposes. Some staff have taken part in mental health awareness training as required from previous Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 19 inspections. There is now a training matrix in place and the home has been committed in ensuring all staff receive mandatory training. The deputy manager is considering completing a trained trainer course in order that some mandatory training can be provided in-house. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 41, 42 and 43. The service users benefit from a well run home. There is a very positive atmosphere and culture within the home. Quality assurance systems are in place. Adequate policies and procedures have been developed. The health, safety and welfare of service users is protected and the home is competently managed. EVIDENCE: The registered manager is a Registered Mental Nurse and has many years of experience in home management. To his credit, despite the fact that he is approaching his retirement age, he commenced his NVQ level 4/Registered Manager’s Award in August 2005. Tasks are delegated to staff dependent on interest and experience and the manager receives excellent support from his senior staff in particular. The home has undergone significant change over the past 18 months throughout many aspects of the service. Staff stated that they now feel “very well supported” and that “everyone pulls together”. The management of these Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 21 changes have been handled very well ensuring that staff can see the benefits of the improvements. Team members now take on specific roles in the home and contribute to the planning of care. There is a positive approach to staff development and a greater focus on the individual and group needs of the service users. The responsible individual and other senior managers visit the home on a very regular basis and staff commented that they are “very approachable and open to ideas”. There is a welcoming and friendly atmosphere in the home and residents stated that they “enjoy living here”. The responsible individual now ensures good quality monitoring is in place. Senior managers visit the home on a weekly basis and provide good levels of support. Regulation 26 monthly monitoring visits are completed and sent to CSCI. There is evidence of continuous improvement both environmentally and staff development. The home is planning on commencing a process of satisfaction surveys for staff, service users and other stakeholders. All records relating to health, safety and welfare were up to date and well maintained. Fire safety and accident logs were complete. A fire and other environmental risk assessments have been developed. All routine maintenance checks have been completed and contracts are in place. The home recently commissioned an occupational therapy report ensuring that the environment is safe and suitable for the service user’s requirements. Staff participate in a TOPSS induction programme and receive mandatory training. The home has adequate insurance cover in place and the management processes of the organisation are positive and supportive of the service. The responsible individual and staff in the home have worked collaboratively to maintain the improvements in the service provision. It was reported that the home is in a financially stable situation. 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded Homeleigh (Commendable) 3 Standard Met (No Shortfalls) Version 1.20 Page 22 H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc 2 Standard Almost Met (Minor Shortfalls) 1 Standard Not Met (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 3 x 3 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 3 x x x 3 Standard No 11 12 13 14 15 16 17 2 x 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 3 1 Standard No 37 38 39 40 41 42 43 Score 2 4 3 x 3 3 3 Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 23 No 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 YA21 Regulation Requirement The Responsible Individual to apply for a variation of registration to include all service users over the age of 65. Timescale for action 01/12/05 2. 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. 3. Refer to Standard YA11 YA25 YA37 Good Practice Recommendations To highlight life skills training guidance in service user plans. To replace vinyl floor coverings in bedroom areas. The registered manager to continue to work towards his NVQ 4/RMA. Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Homeleigh H56-H05 S23280 Homeleigh V243411 041005 Stage 4.doc Version 1.20 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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