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Inspection on 06/02/06 for Homeville

Also see our care home review for Homeville for more information

This inspection was carried out on 6th February 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service users enjoy a quality of life that includes age appropriate activities and individual flexible routines. Staffing numbers are adjusted to enable service user to participate in their chosen activity and to enable them to go on holiday. Service users can go on holiday a couple of times a year and this includes holidays abroad. Personal references are respected and is reflected by the way the registered provider has considered whether or not fill the vacancy. Any prospective service user would be gradually introduced and the existing service users views sought. The acting manager responds appropriately to requirements made. Over 50% of the care staff have completed the NVQ training with only one carer remaining to enrol on the course.

What has improved since the last inspection?

The acting manager has developed a document to assist with the assessment of prospective service users. The long-term up-keep and maintenance of the building now has a basic plan. Some refurbishment of the building has occurred since the last inspection. The procedures for preventing the spread of infection have improved and the acting manager has provided the appropriate equipment, such as gloves and aprons, liquid soap and paper towels. Staff have completed a number of training courses over the last year but this needs to be developed further. The processes used for recruiting staff has improved greatly, all of the required documentation is within their file and the acting manager ensures new staff are closely supervised at all times. A monitoring system has been introduced for assessing the quality of service the Home provides. Health & safety checks have been conducted at the required time and recorded. A new complaint form has been implemented.

What the care home could do better:

Nine of the ten previously made requirements have been met or partially met. Daily reports need to be signed by staff and show evidence that any concerns raised are being monitored. Care plans need to include any changes in care needs identified in areas such as daily reports. Staff need to be aware of the complaints procedure and of the new processes being implemented within the home. Service users would benefit from having regular nutritional assessments conducted. If new staff start work before the CRB is returned then a POVA First check needs to be completed. Staff should attend the mandatory training courses such as movement & handling. The registered provider needs to do monthly unannounced visits to the home and write a report on their findings.

CARE HOME ADULTS 18-65 Homeville Homeville 95 Victoria Road Margate Kent CT9 1RD Lead Inspector Clair Brown Unannounced Inspection 6th February 2006 09:30 Homeville DS0000023224.V276870.R01.S.doc Version 5.1 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.V276870.R01.S.doc Version 5.1 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.V276870.R01.S.doc Version 5.1 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 Mr Paul Rollins Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Homeville DS0000023224.V276870.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2005 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 DS0000023224.V276870.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the Homes unannounced inspection. The registered provider owns a total of three small homes within the area, all providing a similar service. The Homeville inspection was conducted by one inspector in one day and the duration was 3 hours. The Homes representative was the acting manager. Additional time was spent in planning the inspection and report writing. The inspectors spent time talking to 2 service users and 2 staff these were actively involved in the inspection. Time was also spent observing interaction between staff and service users. Documents and records were examined, service users and staff files were case tracked. What the service does well: What has improved since the last inspection? The acting manager has developed a document to assist with the assessment of prospective service users. The long-term up-keep and maintenance of the building now has a basic plan. Some refurbishment of the building has occurred since the last inspection. The procedures for preventing the spread of infection have improved and the acting manager has provided the appropriate equipment, such as gloves and aprons, liquid soap and paper towels. Staff have completed a number of training courses over the last year but this needs to be developed further. The processes used for recruiting staff has improved greatly, all of the required documentation is within their file and the acting manager ensures new staff are closely supervised at all times. A monitoring system has been introduced for assessing the quality of service the Home provides. Health & safety checks have been conducted at the required time and recorded. A new complaint form has been implemented. Homeville DS0000023224.V276870.R01.S.doc Version 5.1 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.V276870.R01.S.doc Version 5.1 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.V276870.R01.S.doc Version 5.1 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): 2 There is now formal documentation for the assessment of needs of a prospective service user. EVIDENCE: Although the home has one service user vacancy, currently there are no plans to fill this. However the home needs to be prepared in case the situation changes. Therefore the acting manager has developed a pre-admission assessment tool for assessing the needs and suitability of prospective service users. Homeville DS0000023224.V276870.R01.S.doc Version 5.1 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 Care plans and daily reports continue to improve but still need to be developed further EVIDENCE: One service users files was case-tracked. This contained a care plan and behavioural triggers and risk assessments and records of medical visits. The daily reports showed that not all of the changing needs identified in the reports were not crossed referenced to the care plan. One service user has developed some problems relating to continence, this was clearly recorded in the daily reports but not in the care plan. The daily records did not clearly show that appropriate follow up action was taken even though staff were able to explain what course of action was taken. Homeville DS0000023224.V276870.R01.S.doc Version 5.1 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 the following standard(s): 11,12,13,14,17 Service users are supported to participate in activities of their choice and to attend further education. A nutritious and varied diet is provided but needs supporting by nutritional assessments 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. Service users attend college for a variety of course such as Yogacise. The service users are supported with the preparation of their meals but there is no form for conducting a nutritional assessment. Homeville DS0000023224.V276870.R01.S.doc Version 5.1 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 the following standard(s): These standards were inspected at the previous inspection. EVIDENCE: Homeville DS0000023224.V276870.R01.S.doc Version 5.1 Page 12 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 The staff are not aware of their role and the procedures for the handling of a complaint. EVIDENCE: The acting manager has developed a new form for the recording of complaints, which should maintain confidentiality. When talking to staff they were unaware of the new form and did not know what to do if they received a complaint. Homeville DS0000023224.V276870.R01.S.doc Version 5.1 Page 13 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): 24,30 The building is adequately maintained and new infection control procedures have been introduced. EVIDENCE: Ongoing maintenance work has been carried out with records of work completed being kept. A basic maintenance plan was introduced for the last half of 2005 but this now needs updating to show forward planning for 2006/07. The staff confirmed that equipment for infection control practices are now provided, such as liquid soap, paper towels, gloves aprons, alginate bags and pedal bins. Homeville DS0000023224.V276870.R01.S.doc Version 5.1 Page 14 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 Recruitment procedures are improved but needs to be developed further to ensure the safety and welfare of the service users. . Staff have not completed mandatory training. 50 of care staff have achieved NVQ level 2 or 3 qualification. EVIDENCE: Over 50 of the care staff have completed the NVQ level 2/3 in care training. Although the training matrix records that staff have attended a variety of training courses these have not included all of the required mandatory courses. A new care staffs’ file was seen to assess the recruitment procedure used. This has greatly improved with all of the required documentation within the file. However the CRB was sent prior to employment but was not returned until after employment had started. There was no POVA First check conducted although staff and the acting manager confirmed that the new person worked under constant supervision until the CRB & POVA check was back. Homeville DS0000023224.V276870.R01.S.doc Version 5.1 Page 15 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): 38,42 Overall the home is managed well but will benefit from further development in this area. Specialist engineer safety checks are conducted appropriately. EVIDENCE: The acting manager has applied to become the registered manager of the home. She has responded appropriately to the majority of the previously made requirements but the staff need to be kept informed and updated of these changes. The gas certificate and electrical certificate were both current and in date. Homeville DS0000023224.V276870.R01.S.doc Version 5.1 Page 16 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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 X 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X 3 X X X 3 X Homeville DS0000023224.V276870.R01.S.doc Version 5.1 Page 17 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 Standard Regulation Requirement Changes in services users needs must be included in the care plans. Daily reports must be signed by staff and show evidence of following up any concerns raised. Nutritional assessments are needed for all service users. All staff must be aware of the complaints form and the procedures when receiving a complaint. The building maintenance programme must be developed to plan for 2006/07. Staff working at the home before the CRB is back must have a POVA First check completed. All staff must complete mandatory training courses, including movement & handling. Previous requirement: 31.12.05 Regulation 26 visits to be conducted and a report produce and sent to CSCI. Timescale for action 31/03/06 YA6YA7YA9YA41 12,13,14, 15,17 2 3 YA17 YA22 14,17 schedule 3 17,22 31/05/06 31/03/06 4 YA24 13,23 31/03/06 5 YA34 7,8,9,19 schedule 2 12,13,18 31/03/06 6 YA35 31/05/06 7 YA39 10,12,15 ,24 31/03/06 Homeville DS0000023224.V276870.R01.S.doc Version 5.1 Page 18 This was a previously made requirement. 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 action on how to meet these needs. To reorganize and review the Homes policies and procedures, ensuring their accessibility for all. Homeville DS0000023224.V276870.R01.S.doc Version 5.1 Page 19 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.V276870.R01.S.doc Version 5.1 Page 20 - 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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