CARE HOME ADULTS 18-65
Homeville Homeville 95 Victoria Road Margate Kent CT9 1RD Lead Inspector
Clair Brown Key Unannounced Inspection 10th August 2006 11:20 Homeville DS0000023224.V302363.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 Homeville DS0000023224.V302363.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. Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Homeville Address Homeville 95 Victoria Road Margate Kent CT9 1RD 01843 223455 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) Mr Paul Rollins Jolene Kelly Rollins Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12th August 2002 Brief Description of the Service: Homeville is a terraced property with accommodation on three floors. It is situated in close proximity to the local shops, park, bowling alley and other public amenities. Single room accommodation is provided for all service users. There is registered manager and the Home employs a team of support workers. They work a rota that includes one staff member on sleep-in duty at night, further staff are available on-call in the event of an emergency. The aim of the Home is to provide a family environment that will enable them to settle and integrate within the community and to become accepted and valued as individuals. The Fees are £1,100 to £2,600 per week. Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection consisted of an unannounced visit to the home on 10th August by one inspector. The inspection takes account of information received from a variety of sources including written information from the registered providers, care managers. The previously made requirements and recommendation from other inspections were inspected and all key standards. The inspector spent time observing and talking to service users to gain their views. A partial tour of the premises was conducted. Documents and records were seen and service users files were case tracked. What the service does well: What has improved since the last inspection?
The registered manager and the staff have worked hard to meet a number of the previously made requirements. The care plans are more detailed and regularly reviewed, supported by clear records of the service users day (daily records). Nutritional needs are now included in the care plan. The building maintenance programme has been produced for the home, although it needs further development. Staff have attended mandatory training courses or are booked to attend them in the near future. The annual quality assurance programme has been completed and a report produced. Persons have been nominated to take on the responsibility for the weekly fire alarm tests. At staff meetings they have been informed of the amended complaints procedure. Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 6 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. Homeville DS0000023224.V302363.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 Homeville DS0000023224.V302363.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 25 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” A formal documentation for the assessment of needs of a prospective service user is being developed. The service user contract should be reviewed and updated. EVIDENCE: A new pre-admission assessment tool has been produced. At the time of the inspection visit, the home only has one vacancy, however to admit a new service user would cause the others a great deal of distress, therefore the company has decided not to fill the vacancy at this time. Each service user has a contract however these do not include the provision of care and care staff under the section for “ what are included in the fees”. Although these are referred to in other sections of the contract Homeville DS0000023224.V302363.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 10 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Service users files have adequate information to provide care to meet service users needs. Behaviour needs are met with evidence of good multi disciplinary working taking place. Confidential information is stored securely. EVIDENCE: Service users care plans identify their needs including aspects relating to behavioural issues, this includes monitoring of events and possible triggers. The majority of daily records now provide a clear picture of the service users day, the care provided and the indications of possible seizures and displays of individual behaviours. Each service user has their own risk assessments, however some of these clearly recorded they needed changing to reflect the current circumstances and this had not been done. All of these documents provided evidence that they are supported to participate in daily living
Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 10 activities. Secure facilities are provided for the storage of confidential records and all service users records are recorded individually. Homeville DS0000023224.V302363.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 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 are supported to participate in activities of their choice and to attend further education. A nutritious and varied diet is provided. EVIDENCE: Service users have two holidays a year one funded by the home. Activities include going out on trips, college, bowling, swimming, walks, bike riding club, holidays as well as day-to-day independent living activities, such as going food shopping. One service user survey commented that they really liked the activities and outings. Meals are chosen daily by service users according to their preferences, with staff ensuring a balanced diet is achieved, although there is a menu to follow if needed. Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 21 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Service users are supported with dignity and respect when personal care is provided. The health needs of service users are met and there is some evidence of good multi disciplinary working taking place. Staff are aware of emotional and behavioural triggers and respond appropriately. Medication policies and procedures are in place for staff to follow. EVIDENCE: The medication policy has been reviewed and now includes procedures for emergency medicines. The service users are currently not taking any prescribed medicines. Daily reports record that personal care and emotional needs are being met. Staff are aware of what can cause a service user to become agitated or distressed and the appropriate action to take to pacify the situation, or even avoid it occurring. Observations of interactions between staff and service users were positive and dignified. Records show that health care
Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 13 professionals are accessed appropriately and service users are supported to attend appointments. The new policy for managing the needs of an ageing service user needs does not include action to be taken by the home to support them staying in the home rather than having to relocate them. Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Policies and procedures are implemented for dealing with complaints and adult protection issues. EVIDENCE: The registered manager plans to update the adult protection policy to comply with current practice; she stated she gained valuable understanding and knowledge through recent alleged incident at another home. No new complaints and staff are aware of new complaints procedure. Accounts and receipts are kept of service users monies and also have their own savings account. Procedures need to be in produced to ensure service users safety when withdrawing money from the bank. Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 25 28 29 30 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” The building is well maintained and meets the needs of the service users. EVIDENCE: The registered manager stated the maintenance programme needs revising to be more detailed and also to amend it following the delays to routine maintenance work following the washing leaking causing a ceiling to collapse in the office. The hall area has been redecorated. Service users were observed enjoying the communal areas of the home. The home was clean and free from offensive odours. Service users took pride in showing the inspector their bedrooms and how they had personalized them. Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 33 34 35 “Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service.” Recruitment procedures are poor and place service users at risk. Staff have gained appropriate knowledge and skills via their training programme. EVIDENCE: Both service users require 1:1 and 2:1 support depending on their routine that day; at the time of the inspection there was the registered manager and two carers on duty. The care staff also undertakes cooking, cleaning and laundry duties. The duty rotas show that the staffing numbers are adequate when all staff are available, however many work overtime and there is no allowances for staff holidays, sickness and training. The registered manager has enrolled staff on mandatory training programmes and needs to ensure all staff completes the required mandatory courses, as well as other appropriate training. 45 of the care staff has completed the NVQ training. The registered manager needs to ensure that this has included the Learning Disability Award Framework. The induction programme has been update to comply with the guidance from “Skills for Care” and the registered manager monitors staffs progress on completing it. The two newly recruited members of staffs files were assessed. Both staff started work before the CRB was received and one before the receipt of the POVA first check. There were no
Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 17 interview records and no evidence of gaps in employment history’s being investigated. Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 38 39 40 41 42 “Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service.” The registered manager has the skills required for the role of manager but the overall management is impacted upon by the actions of the registered provider. The quality of service provided is annually assessed and monitored. The health & safety and welfare of both staff and service users are not ensured by current procedures. EVIDENCE: Since the last inspection the acting manager has successfully become the registered manager, therefore she is appropriately qualified and has the experience to manage the home. Policies and procedures have been reviewed and updated by the registered manager. Records such as daily reports have improved significantly these now provide a clear account of the service users
Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 19 day, including care provided and the detailing of behaviours and outcomes. The majority of the environmental certificates and the insurance were in date, however the gas certificate had expired. The annual quality assurance programme has been undertaken this year and a report produced. However the registered provider needs to make arrangements for the regulation 26 monthly visits. Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 20 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 N/A 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 2 3 2 2 3 3 2 X Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 21 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. 2. Standard YA2 YA6 Regulation 5 12-15 17 Requirement Timescale for action 30/11/06 The service users contract needs to specify that 24hr care is included in the fees. The registered manager must 30/11/06 use a cross-referencing system between the care plan and other sections of the service users file such the guidelines. Risk assessments must be 30/08/06 amended as soon as changes in actions and needs are identified. The building maintenance 30/11/06 programme needs to be updated to reflect the current situation and ensure work is completed. Staff working at the home before the CRB is back must have a POVA First check completed. Previous requirement: 31/03/06 Regulation 26 visits to be conducted and a report produce and sent to CSCI. Previous requirement:
DS0000023224.V302363.R01.S.doc 3. YA9 12 13 4. YA24 13,23 5. YA34 7,8,9,19 schedule 2 30/08/06 6. YA39 10,12,15,24 30/10/06 Homeville Version 5.2 Page 22 31/12/05, 31/03/06 7. YA42 12 13 16 17 23 The gas certificate must be 37 renewed at the appropriate sch 3 intervals. Confirmation of this to be sent to the CSCI office. Risk assessments are needed for the hot surfaces such as radiators and if they are deemed to need guarding then they must be guarded. 30/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA21 Good Practice Recommendations To develop further the procedure for monitoring the ageing needs of the service users and then action how to meet these needs. This should include considering adapting the building prior to relocating the service user. All staff must complete mandatory training courses, including movement & handling. To review the current staffing levels to ensure there are sufficient numbers of care staff employed to cover annual leave, sickness and training. 2. 3. YA35 YA33 Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Homeville DS0000023224.V302363.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
