Inspection on 18/04/07 for Inchwater

This inspection was carried out on 18th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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

Inchwater 30/01/06

Inchwater 10/10/05

Inchwater 16/11/04

Inchwater 12/07/04

Inchwater 13/02/04

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Thorndene

Insight - Eastchurch

Southfields

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33 St John`s Church Road

Dovedale Court

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Inchwater 92 Maison Dieu Road Dover Kent CT16 1RU Lead Inspector Julie Sumner Unannounced Inspection 18th April 2007 10:00 Inchwater DS0000023223.V307191.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 Inchwater DS0000023223.V307191.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. Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Inchwater Address 92 Maison Dieu Road Dover Kent CT16 1RU 01304 226445 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 Watts Mr Paul Watts Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: Inchwater is a family run home registered to care for and support three adults with learning disabilities. The owners live in the home with their children and one part-time member of staff is employed. The aim is to provide a home for life, integrated with the family. Two gentlemen currently live at Inchwater and have done for over 5 years. One service user has needed to move on so there is one vacancy. The current fees for the service at the time of the visit are £657.59 per week. This fee can be increased to the assessed needs of the residents. There are additional charges for chiropody, hairdressing, magazines, clothes and toiletries. The home pay for one holiday a year and residents are assisted to go on holiday more often if they wish to and can afford it. Information on the homes services and the CSCI reports for prospective service users/relatives will be referred to in the Statement of Purpose and Service User Guide. The home is a large Victorian period property with good sized communal rooms and bedrooms, which are all single. There are stairs to access the different floors therefore the current facilities are unsuitable for someone with mobility difficulties. There is a parking space in front of the home and a spacious garden at the back. The house is situated on the outskirts of Dover town centre and is within easy reach of all amenities and public transport. Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection. The inspector visited the home to talk to residents and staff and view records and practices. Information was gathered for this inspection in a variety of ways both prior to and during the visits to the home. Surveys have been completed by relatives and visiting professionals in previous inspections and all past comments have been positive. There were no comments received at this time. On the first visit both residents were out so a visit was arranged the following day. The time spent in the home overall was just over 6 hours. The people living at Inchwater have limited communication skills and are not able to fully participate in the inspection. Time was spent with the residents whilst they carried on with their usual routines for this day and one resident talked a little, answering some questions about his lifestyle. Examples of comments were: “likes gardening, likes going out for lunch” and it was evident that both residents were able to make their wishes known to the owners and staff. There is currently one vacancy due to one of the residents moving to a home providing nursing care. A new brochure has been designed giving an insight into the support offered by the home to prospective residents. There were no outstanding requirements from the previous inspection. Some progress had been made on the two recommendations from the previous inspection but there was still some work to do so these have remained in this report. Some other improvements needed were also discussed but no further recommendations were made as a result of this inspection. What the service does well: A good quality of care and support is given to the residents living in Inchwater who benefit from a family style environment. Communication is good within the home with residents being able to make their needs and wishes known and the owners and staff interpreting and responding to them. The day is well organised so that there is a mixture of daily household chores, outdoor activities, activities set in the community and leisure both in and outside the home. The owners are motivated and continue to improve and develop the services provided to the residents. Inchwater DS0000023223.V307191.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 Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 8 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 Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provide clear information and assessments are carried out prior to admission to make sure prospective residents’ needs can be met. EVIDENCE: There have been no new admissions. There is currently one vacancy. The owners have designed a brochure and have been contacting funding authorities and care management teams but have had no appropriate referrals up until now. The care manager/social worker making the referral carries out initial assessment and then this is updated by the owners. Assessments for the current residents have been viewed at previous visits. Inchwater DS0000023223.V307191.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owners are aware of the importance of people taking control of their own lives and support this in practice. A clearer written plan involving residents would give a more focused approach to seeing how independent living skills are developing. EVIDENCE: The content and design of the service user plans and risk assessments were discussed with the owners. They are based on the care plan written by the care manager who has been reviewing the care provided every six months. They contain clear information about abilities, needs and how to manage this safely whilst developing life experiences. The owners and staff have got to know the residents well to gather this information. Residents were observed making choices about what they wanted to do in various ways and being responded to. At present the residents are not involved in the content of the plan and when talking with them there was no indication from either person that they want to Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 11 be. There was a discussion about designing person centred plans and different ways the residents could be involved in creating them if they wish to. The owners are going to make the plans for the people living in Inchwater person centred. Inchwater DS0000023223.V307191.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in Inchwater are involved in family life and are assisted to maintain relationships that are important to them. They are involved in meaningful activities of their own choice including participating in providing the home grown food. EVIDENCE: Parts of the days are made up of routine tasks and set times for attending the local day opportunities centre where they have got to know other people there who they socialise with at the planned events. The remaining time is flexible and residents are given choices from a range of familiar tasks and some new experiences. One resident said he likes gardening which he does both at the home and at the day centre. He also likes going to the cinema and goes whenever there is a film on that he wants to watch. Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 13 Holidays are arranged each year and these have ranged from active surfing holidays in Cornwall, walking holidays in Wales and short city breaks. The residents have lived in Inchwater for over seven years and the owners and staff have got to know them very well. There was a discussion about assisting their communication so that they would be able to talk or interact with other people more easily and to assist with making choices when away from the home. Speech and language therapy advice has already been sought and their advice taken into account but it was agreed that further support for communication is needed which the owners are going to pursue. The owners continue to help one of the service users keep in touch with relatives abroad through sending pictures and letters via e-mail, phone calls and through the post. One of the service users is supported to visit his mother as often as they both want. The owners and staff keep relatives informed with service users well being. Individuals are encouraged to choose their lifestyle: activities, meals and what they want to wear depending on whether they want to and what their current level of ability is. Support needed and preferences are documented in the service user plan. Meals are home cooked or they go out to eat. One of the service users said he liked helping in the garden and they had grown potatoes which are his favourite. Menus are flexible and depend on what everyone feels like eating, the weather and what food is in season. The owners said they continue to like to grow their own organic vegetables and fruit which the service users participate in. Inchwater DS0000023223.V307191.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 at least once during a 12 month period. 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 are supported to live a health lifestyle and assisted with medical help if the need arises. EVIDENCE: The residents are assisted to attend regular health check appointments including dentist and optician. All appointments are recorded in the home diary. There is a small amount of medication in the home. The member of staff talked about what medication was prescribed the storage was viewed and the records were clearly completed and up to date. The owners and member of staff have attended medication training and updated the policy which was viewed at the previous inspection following their 3 month training course. Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a working complaints system and arrangements are in place to safeguard residents. EVIDENCE: The home has a simple complaints procedure and there is a log book available to make records. There have been no formal complaints since the home opened. The owners said that if any issues were to arise they would probably be discussed and they would find a way to resolve it. The home has an Adult Protection Policy, which includes whistle blowing, and the owners and staff have received Adult Protection training. Each service user has an inventory of their belongings. There are financial systems in place to record service users monies. Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard and cleanliness of the home is very good providing people with an attractive, safe and homely place to live. EVIDENCE: The home is well maintained and decorated providing residents with an attractive and homely place to live. Equipment and adapted furniture has been provided to provide maximum support to residents’ lifestyles. Residents have bedrooms that have been furnished so that they can spend time on their own if they want to have some quiet time or they can join in with the family. The home is clean and laundry facilities are appropriate and efficient for the needs of the household. Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 17 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, 34, 35 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 by competent staff who have got to know individuals well. EVIDENCE: The owners have continued to research information regarding the client group and to access appropriate training. There is one member of staff who has achieved NVQ level 2. He has received all the mandatory training including medication training. No new staff have been recruited and the owners and staff have had CRB checks processed. Inchwater DS0000023223.V307191.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, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owners are person centred in their approach and have good business planning skills. Good quality monitoring and a written development plan would enhance the development of the service provided to residents. EVIDENCE: Both Mr and Mrs Watts have various relevant qualifications and have over 8 years experience in caring for and supporting people with learning disabilities. Residents looked contented and well. Good interaction between residents and the people supporting them was observed. The owners judge the quality of the service and decide what needs to improve or develop by discussion with eachother, the member of staff and other people involved with the support of the residents. Contact with relatives is maintained by telephone and in writng. Surveys are sent out to the relatives as part of Inchwater DS0000023223.V307191.R01.S.doc Version 5.2 Page 19 the inspection process but not as part of the home’s own quality assurance monitoring. The owners need to design some written feedback questionaires to gather views on how the service is meeting service users needs. This should include the views of other people involved in their care like care manager, community specialists and relatives. A development plan needs to be designed incorporating the views gathered. It also needs to include developing individual life skills and experience and any planned improvements to the home and what is being provided. The owners agreed to do this and started discussing how they would go about it during the inspection. The home is kept in safe working order with regular servicing and there is a linked fire protection system. All relevant records are kept in the home. The owners and staff have attended health and safety training. Inchwater DS0000023223.V307191.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 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 3 25 x 26 x 27 x 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 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 3 x Version 5.2 Page 21 Inchwater DS0000023223.V307191.R01.S.doc 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. 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 YA35 Good Practice Recommendations Continue to develop training plan for developing knowledge relevant to people with learning disabilities and including ageing. The quality monitoring system needs to be more formal by including feedback and designing a development plan for the home based on outcomes from quality monitoring. 2. 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