Inspection on 17/06/08 for Homeville

This inspection was carried out on 17th June 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Homeville 09/08/07

Homeville 10/08/06

Homeville 06/02/06

Homeville 20/06/05

Homeville 22/02/05

Homeville 14/05/04

Homeville 13/02/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Homeville Homeville 95 Victoria Road Margate Kent CT9 1RD Lead Inspector Wendy Gabriel Unannounced Inspection 17th June 2008 10:10 Homeville DS0000023224.V365399.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.V365399.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.V365399.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) jolene_rollings@fsmail.net Mr Paul Rollins Jolene Kelly Rollins Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th August 2007 Brief Description of the Service: Homeville is a terraced property with accommodation on three floors. Single room accommodation is provided for both service users. There is a small garden to the rear of the property. It is situated in close proximity to the local shops, education centre, park, bowling alley and other public amenities. There is limited parking in the road outside of the home. The aim of the Home is to provide a family environment that will enable service users to settle and integrate within the community and to become accepted and valued as individuals. Fees are in the range of £1149.41 - £2722.07. For further information please contact the registered provider. Homeville DS0000023224.V365399.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 the people who use this service experience good quality outcomes. There were two support staff and the maintenance man on duty at the time of the unannounced inspection and the registered manager. The two residents were about to leave the home for their daily activities and one said that he was going to the college for dance and that he liked this very much. Staff accompanied both service users at this time. Staff also briefly spoke to the inspector about their training. As well as ongoing mandatory training courses, the home has achieved 100 NVQ (national vocational qualification) for all staff including three people with NVQ level 3. Inspection methods used during this visit included looking at documents and records, an accompanied tour of the premises, looking at care plans for both people who live in the home and at two staff files. We looked at the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. What the service does well: The service provided a very clear and comprehensive AQAA when we asked for it. The registered manager gave a good account of improvements planned for the coming year. The house is an older style terraced property and has inherent problems regarding access to the garden and the siting of the laundry. However, the home is actively maintaining a comfortable and homely environment by undertaking a redecorating program that this year will include bedrooms, hall, stairs and kitchen, new carpets and new suite to the lounge. Homeville DS0000023224.V365399.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 be made available in other formats on request. Homeville DS0000023224.V365399.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.V365399.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1.2. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Prospective residents receive information that enables an informed choice to be made regarding where to live. Prospective residents know that their needs will be assessed and met. EVIDENCE: The registered manager has worked on providing a more comprehensive statement of purpose. This was a requirement made at the last inspection. The statement of purpose had not been printed at the time of the inspection (but was seen on the homes computer). The home was not anticipating admitting another resident in the near future. This is because they did not want to unsettle the current people living in the home and their balanced way of life. However, the document will be available when and if they decided to admit a third person to the home. The service user guide was clear and comprehensive and included very useful photos for individual residents and their activities and lifestyles. The guides clearly indicated what life in the home is like. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 9 The registered manager said that she would visit a prospective resident in their own home and then a period of visits by the individual would be made to the service including overnight stays. A revised pre admission assessment has been prepared should it be required. The two people who live in the home have been living there for approximately 8 years and their management has enabled them both to settle in well. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. 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. Residents know that care planning, review and support meets their needs and that they have a role in making decisions about their care. Confidential information is held in a secure facility. EVIDENCE: The care plans of both residents were viewed and these are clearly detailed to include risk assessments and are cross-referenced to comprehensive behaviour guidelines. The guidelines indicate triggers to behaviours and information for staff to be alerted to a possible behavioural incident or to respond to any incident. There is good use of photographs for staff benefit to compliment guidelines and instructions. This document is user friendly. Risk assessments are comprehensive. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 11 The registered manager organises and undertakes six monthly reviews and includes the family of the individual, key worker, staff and care manager if available. There was evidence of a community nurse in attendance of one review. If family are unable to attend they will be informed of the outcomes. Both records had good evidence of advice and support by health care professionals. Confidential information is kept in a secure office. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.14.15.16.17. Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents enjoy opportunities for appropriate developmental and leisure interests both in the home and the community. Families know they will be made welcome in the home. Residents know they will be treated with respect. Menus are varied and wholesome. EVIDENCE: Opportunities to develop and maintain social, emotional and communication skills are promoted. The home records activities and personal preferences are identified. Most of the staff have worked at the home for some time and have a good understanding of each individual’s needs and choices. Staff are also aware of communication needs. Makaton training can be undertaken to further communication. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 13 The residents attend college or the adult education centre. One person was preparing to leave the home at the beginning of the inspection to attend a drama and dance group. He cheerfully said he enjoyed this very much. Other courses include: - learning about money, time, interaction and road safety. Pottery, reading and writing are also undertaken. Certificates of achievement gained are on display in the home. One person has two budgies and looks after them with support from staff. The home has a vehicle and day trips are undertaken both locally and further afield. The service has the advantage of being able to access the local Winter Gardens theatre for different events. One person has someone come to the home for one to one exercise. Music therapy is also undertaken in the home. Where able, people are supported to be involved with some domestic routines of the home. Families are welcomed and the home has dealt with bereavement to a resident. Since then the registered manager has written a document for one person to be used in event of a close bereavement. This is good practice and illustrates the proactive management of care according to known needs of individuals. One person had just returned from a holiday abroad and had been accompanied on a one to one basis. The second person living in the home will go on his preferred choice of holiday later in the summer. The home pays for one holiday a year per person and any other holidays are self funded. The kitchen/diner was well organised and was being redecorated. All the staff take it in turns with individual resident to choose the weekly menus. This helps to provide a balanced and varied menu. Care plans indicate if resident hold a key to their own rooms. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18.19.20. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents know that their personal, physical and emotional needs are supported in a respectful and appropriate manner. Residents are protected by the homes medication administration policies and procedures. EVIDENCE: Since the last inspection, the home has met the recommendation made for allergies to be recorded on the medication administration recording charts. Medication is secured in a lockable wall-mounted cabinet within a locked room. Staff receive medication administration training. The medication administration record for one day had a gap where a cosignatory should have signed. The registered manager agreed to make sure this was rectified and previous records for recent weeks confirmed that this had not been neglected before. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 15 Healthcare matters are routinely discussed at reviews and there was ample recorded evidence of the home seeking the advice and support of healthcare professionals. Care plans have a robust recording of healthcare appointments and health situations. A body map was in place for a scratch to one person. The registered manager agreed to add the date when any mark or wound had healed, thereby closing the map for individual incidents. The registered manager agreed to record on an administration chart; details of use of a medicated cream. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22.23. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents know they will be protected from abuse because of the policies and procedures maintained and by staff training. EVIDENCE: The home has a complaint procedure and policy. Details are available for resident in a simple and clear format. No complaints had been received since the previous inspection. Following a recommendation made at the last inspection, a staff meeting was held to discuss whether any behavioural issues of residents would be deemed as a complaint. The home now records these with outcomes and any further action that was or would be taken. Staff receive challenging behaviour and adult protection training. Part of staff meetings is used to focus on different procedures and policies including adult protection and abuse where staff and the registered manager will recap on procedures. Finances are recorded individually and records are cross checked by a second member of staff. A sample checked of records and cash held was accurate. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 17 The registered manager is aware of adult protection procedures. In September she is to attend training for trainers in adult protection. The home has policies on whistle blowing, respectful working policy, racial harassment, management of service users money, equal oportunities and race equality and bullying. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24.25.27.30. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents live in a homely and safe environment but this will be improved by guards to radiators, removal of rubbish from the garden and maintenance of the shower room. The planned maintenance program will improve the environment for service users. EVIDENCE: The downstairs shower has a crack to the ceiling and the base of the shower door is rusty/dirty. The maintenance man said the floor is to be replaced and that the unhygienic wooden raised floor around the wc is to be recovered. The garden has an old mattress in it that the registered manager said is to be removed. The home is over three floors and the age and style of the building makes two matters problematic and difficult to resolve. Leaving the home and entering the lower ground floor ‘flat’ from the pavement is the only means of accessing Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 19 the garden and the laundry area. This is inconvenient for residents and for staff. The registered manager and the registered provider are considering ways of making this more accessible. The home is clean, comfortable and there are homely touches. There is a full programme of redecoration planned for the coming year that includes bedrooms, hall, stairs and kitchen, new carpets and new suite to the lounge. A recommendation made at the last inspection to justify non-provision of bedroom furnishings in line with the National Minimum Standards has been met and records are now maintained of reasons for this. The home has also undertaken a programme of repair and redecoration over the past year, including the fire officers’ recommendations that have been reassessed by a specialist company in December 2007 with no further recommendations. One bedroom has an en-suite wc and the other is close to a wc. There is a choice of bathroom or shower room and wc facilities are on both floors. Bedrooms are individual and one was in the process of preparation for redecorating. People who live in the home are encouraged to personalise their bedrooms. There is a potential risk to people from unguarded radiators but the registered manager said this was to be reviewed during the redecoration and maintenance programme for this coming year. The lounge is domestic in style and light and spacious and one resident was seen freely accessing it. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32.34.35. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-trained and competent staff team. Residents benefit from improved recruitment check procedures. EVIDENCE: The registered manager said that the home is fully staffed. A member of staff sleeps in the home each night and is on call. The registered manager is also on call in an emergency. Staff undertake cooking and cleaning duties as well as support work. Residents are also supported to undertake some household tasks. The home maintains supervision and there was recorded evidence of appraisals being recently undertaken. A previous recommendation for staff to complete mandatory training has been undertaken and there was evidence of a training matrix in the office for courses to be taken and when to be updated. The home has achieved 100 NVQ for the staff and this includes two support workers and the maintenance Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 21 man with level 3. The AQAA states that all staff has been enrolled on distance learning courses including nutrition, equality and diversity, and dementia awareness. A recommendation was made at the last inspection for improved recruitment checks. Some CRB (criminal record bureaux) checks were to be properly documented and the registered manager stated that she has responded by redoing the checks. The registered manager has also produced some recording formats to improve recruitment procedures such as a format for interviewing. Induction takes up to 12 weeks and the home uses the ‘skills for care’ format. New staff has to shadow an experienced member of staff and are supported by senior staff and the registered manager. New staff has to have the CRB and PoVA First (protection of vulnerable adults) checks in place before commencing work. Staff receive the employee handbook and health and safety handbook. Monthly staff meetings take place and a record of these was viewed. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37.39.42. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home. Policies and procedures protect residents. Health and safety is supported by policies, procedures and risk assessments and the residents will benefit when some general maintenance is completed. EVIDENCE: The registered manager has the required qualifications and experience and has managed the home for several years. She has a clear understanding of the principles and ethos of the home. The service users benefit from a wide range of activities and have access to community resources. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 23 The registered manager has undertaken a Quality Assurance and monitoring process and there was evidence of good responses from care management and families about the care of the service users. A requirement made at the previous inspection has been met regarding Regulation 26, whereby a representative of the company visits the home monthly to do their own inspection. The registered manager has provided a plan for the coming year in regard to improvement to the building including repair, replacement and redecoration. Some of this was seen to have commenced at the time of the inspection. The home has all the necessary insurance cover in place and in date. The homes fire record book was in date. Environmental risk assessments are in place and COSHHE is secured safely in a lockable facility. A recommendation is made regarding some health and safety matters. These include ridding the garden of an old mattress and decorators/builders’ materials. The shower is to be maintained with new covering to the floor and the raised wc. The ceiling in the shower is to be repaired and the shower door cleaned. Radiators are not covered. The registered manager agreed to these and some were already in the maintenance plans. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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 YA24 Good Practice Recommendations • • • Radiators are to be assessed for covers. The shower is to be maintained to repair the ceiling and clean the shower door base. The old mattress is to be removed from the garden. Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 26 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 Homeville DS0000023224.V365399.R01.S.doc Version 5.2 Page 27 - 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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