Inspection on 20/06/05 for Homeville

This inspection was carried out on 20th June 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Homeville 17/06/08

Homeville 09/08/07

Homeville 10/08/06

Homeville 06/02/06

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 09/07/2008.

CARE HOME ADULTS 18-65 Homeville Homeville, 95 Victoria Road Margate Kent CT9 1RD Lead Inspector Clair Brown Announced 20 June 2005 10:10 th 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. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Homeville Address Homeville, 95 Victoria Road, Margate, Kent CT9 1RD 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) 01843 223455 Mr Paul Rollins Mr Paul Rollins Care Home 3 Category(ies) of Learning Disability (3) registration, with number of places Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22.02.05 Brief Description of the Service: Homeville is a terraced property with accommodation on four 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. Mr Paul Rollins is the manager and the Home employs a deputy/quality assurance manager and a further four 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. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the Homes announced inspection. The registered provider owns a total of three small homes within the area, all providing a similar service. It was agreed that the three homes would be inspected together, spending a day in each home, with the registered provider and /or his representative present at all three homes. The Homeville inspection was conducted by one inspector in one day and the duration was 5 and ½ hours. A tour of the building was conducted, documents and records were examined and service users files were case tracked. What the service does well: What has improved since the last inspection? What they could do better: The Home needs to develop a document to assist with the assessment of prospective service users. The long-term upkeep and maintenance of the buildings needs to be planned in advanced. The lounge carpet was heavily stained and would benefit from replacing. The procedures for preventing the spread of infection needs to be improved and the registered manager must ensure the appropriate equipment is provided, such as gloves and aprons, Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 6 liquid soap and paper towels. Mandatory training such as first aid and movement & handling needs to be completed by all staff. The processes used for recruiting staff needs to ensure that all of the safety checks are conducted prior to staff being employed. A monitoring system is required for assessing the quality of service the Home provides. Health & safety checks need to be conducted at the required time and recorded. This includes fire, electrical and gas inspections. 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 H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 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 Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 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) 1,2,3 The statement of purpose provides adequate information to enable prospective service users to make an informed decision. There are no formal procedures and documentation for the assessment of needs of a prospective service user. The service users expressed their individual needs are being met. EVIDENCE: A new statement of purpose has been produced. This document contains the required information and is written in a clear and understandable language. Due to the service the home provides this document would benefit service users being presented in an appropriate format. The copy of the contract was not attached to the statement of purpose, which is acknowledged as a possible oversight. In future this must be included in the document. Service users expressed their contentment whilst living at the Home, receiving a quality of care and lifestyle they enjoy. The Home does not have a pre-admission assessment tool for assessing the needs and suitability of prospective service users. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 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) 6,7,8,9,10 Service users have care plans with risk assessments and records of emotional /behavioural triggers, these are not a current record of service users needs. Confidential information is stored securely. EVIDENCE: The service users files contain detailed care plans, risk assessments and details of emotional/behavioural triggers. However these records are not up to date as they have not been reviewed since July 2004. There are six monthly review meetings of the service users, with care managers and relatives invited to join the meeting. A report following this meeting is produced but the information gathered is not transferred to the actual care plan. The Home is looking at introducing “person centred” plans. Daily reports are not sufficiently detailed and include phrases such as “fine night”. The Home is now registered with Data Protection and confidential files were stored in a locked cupboard. See text for standard 22. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 10 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) 11,12,13,14,15,16,17 Service users are supported to participate in activities of their choice and to attend further education. A nutritious and varied diet is provided. EVIDENCE: The service users are able to talk of the activities and many holidays they have been on. Activities include going out on trips, going to the local nightclubs as well as day-to-day independent living activities, such as going food shopping. Additional staff are provided to support service users individually to fulfil their choice of activity. The service users go on several holidays a year, which vary in destination and type of holiday, such as trips to Tenerife and caravan holidays in England. Meals are chosen daily by service users according to their preferences, with staff ensuring a balanced diet is achieved. Service users are supported to assist with the preparations and cooking of the meal. On the day of the inspection lunch was a homemade lasagne. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 11 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) 18,19,20,21 Service users are supported with dignity and respect when personal care is provided. Medical advice and treatment is sought appropriately. Staff are aware of emotional and behavioural triggers and respond appropriately. Medication is administered and recorded following safe practices and procedures. There is no plan in place for preparing of the ageing of service users. EVIDENCE: Daily reports record that personal care and emotional needs are being met. The registered manager was able describe how behaviour triggers are monitored. 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. Relatives’ responses to the pre-inspection questionnaires say their family member is well cared for and they are happy with the care provided. Medicines are not prescribed on a regular basis for the service users, however they do have short course of medicines. Procedures now include keeping records of medicines received in to the Home. No errors were found in the medication records. The preparation for the ageing of service users was discussed; the registered manager stated that no plans had been made to date. This needs to be kept under regular review to ensure these needs are not over looked. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 12 Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 13 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) 22,23 Service users and relatives opinions are listened to and taken seriously, Procedures are implemented to protect service users from abuse. EVIDENCE: Service users and relatives have said they know who to talk to if they have any concerns and are confident the matter would be dealt with promptly. A revised complaints procedure has been seen. This procedure stated “making entries in a complaints book”, which could raise issues of confidentiality. The complaints procedure does not include the required timescale of 28 days for responding to a complaint. The Home has purchased the Multi-disciplinary team adult protection procedure and added this to the Homes own procedure. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 14 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) 24,25,26,27,28,29,30 The Home provides suitable accommodation for the service users but the Home is not accessible to those with restricted mobility. Management of the maintenance of the building is inadequate. Standard 29 is not applicable. Infection control procedures do not prevent the possible spread of infections. EVIDENCE: The Home is a terraced town house with a flight of steps to the front door and no rear access at ground level. The current service users do not have any mobility problems and are easily able to access the building and do not require any aids or adaptations. Therefore standard 29 is currently not applicable but it will necessary for the registered provider to keep this under constant review as needs change. The Home has three single bedrooms and sufficient communal space to meet the needs of the Home and the service users. There is a small quite/activity room separate to the main lounge. The laundry room has had a hand-wash basin and a new impermeable flooring fitted. Although maintenance has been carried out there is no formal maintenance programme and no records of work being completed. The lounge carpet is heavily stained. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 15 Staff must be provided with the equipment to adhere to infection control procedures, such as liquid soap, paper towels, gloves, aprons and alginate bags for soiled laundry. These must be provided in all areas where personal care is provided. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35,36 Care staff are provided in sufficient numbers to meet the needs of the service users. Recruitment procedures are not thorough and do not ensure the safety and welfare of the service users. A TOPSS induction programmes have been accessed but not implemented. Individual staff training programmes and a training matrix have been introduced. Staff have not completed mandatory training. 50 of care staff have achieved NVQ level 2 or 3 qualification. Existing staff are regularly supervised. EVIDENCE: The Home employs one registered manager, a deputy manager and five support workers. Currently at night, staff are employed on a sleep-in basis. They are paid if they are woken and if necessary sent home from their day shift. The numbers of carers on duty at any one time will vary according to the day to day needs of the Home and the service users. Additional staff are provided to cover outings and activities and holidays. The most recently employed member of staffs recruitment file was assessed. This showed that recruitment procedures had not been followed. Only one written reference had been obtained, no POVA first check had been completed although a CRB had been applied for. The new member of staff was not supervised until these checks had been received and had been working alone in the Home. Staff photographs have been included in their files. New staff are initially started on the Homes basic induction programme, which covers areas of providing basic care and being introduced to the Home layout and basic procedures. The Homes has acquired the TOPSS induction Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 17 programme but has not fully implemented yet. 50 of care staff have achieved NVQ level 2 or 3 qualification in care. A further two staff are currently studying for the NVQ qualification. Individual training programmes and training matrix have developed to identify staffs training needs and to monitor what training is provided. Currently very few staff have completed the mandatory training required such as movement & handling. Staff files show records of formal staff supervision, these sessions have occurred at least six times in the last 12 months. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 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 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) 37,38,39,40,41,42 The management of the Home lacks leadership and a consistent, organized management approach. The quality of service provided is not regular assessed and monitored. The health & safety and welfare of both staff and service users are not ensured by current procedures. EVIDENCE: The registered manager/provider is currently experiencing health problems; this has impacted on his ability to manage the Home. The Commission has been notified verbally. Confirmation of the interim plans for the future management of the Home have been requested in writing. There is no quality assurance programme in place and the monthly visits have not been conducted. Routine health & safety checks and servicing has not been conducted as required. The electrical certificate had expired. The fire safety checks have not been tested quarterly by the specialist engineer despite the Home having a contract with a company for these checks. The Homes policies and procedures have not been reviewed since 09.04, although some have not Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 19 been reviewed for a longer period of time. The files containing these documents were disorganized and with no clear means of sourcing a required policy. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 3 x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 3 2 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 N/A 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Homeville Score 3 3 3 2 Standard No 37 38 39 40 41 42 43 Score 2 x 1 2 x 2 x H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 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 YA6,7,9 Regulation 14,15 12,13,14, 15,17 Requirement A pre-admission assessment tool must be developed and implemented. Service users individual care plans, risk assessments and decision making process must be kept under regular review and updated accordingly. Reviews must occur at a maxumum of six month intervals. Daily reports must provide an accurate account of the days events and refrain from generalized statements. To review the Homes compalints procedure to ensure data protection and confidentiality. Also to include a 28 day time frame for responding to a complaint. The manager must produce and implement a maintenance programme for the building. Records of maintenance work completed must be kept. Infection control procedures that protect both staff and service users must be implemented. These must include the provision of liquid soap, paper towels, gloves, aprons and foot operated Timescale for action 31.12.05 31.12.05 3. YA22 17,22 31.10.05 4. YA24 13,23 31.12.05 5. YA30 12,13,16, 23 31.10.05 Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 22 6. YA34 7,8,9,19 schedule 2 12,13,18 10,12,15, 24 7. 8. YA35 YA39 9. 10. YA37 YA42 9,39 4,13,17,2 3,37 bins. Infection control procedures for handling soiled linen must include the use of alginate bags. A thorough recruitment procedure must be implemented ensuring the safety and welfare of the service users. All staff must complete manadtory training courses. An annual quality assurance programme to be developed and implemented. Regulation 26 visits to be conducted and a report produce and sent to CSCI. This was a previously made requirement :timescale To confirm in writing to the CSCI the provisional management plans for the Home. Gas and electrical servicing and certificates must be conducted at the correct intervals. Copies of the certificates to be sent to the CSCI. Fire tests and servicing of equipement must be conducted at the required intervals. 31.07.05 31.12.05 31.12.05 31.07.05 31.07.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA21 YA40 Good Practice Recommendations To develop and implement a procedure for monitoring the ageing needs of the service users and then actioning how to meet these needs. To reorganize and review the Homes policies and procedures, ensuring their accessability for all. Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 Page 23 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 Homeville H56-H05 S23224 Homeville V 225251 20062005 Stage 4.doc Version 1.30 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. 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