Inspection on 29/03/07 for Insight

This inspection was carried out on 29th March 2007.

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

Insight 30/01/06

Insight 23/03/05

Insight 25/01/05

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 Insight Brusons 5 London Road Teynham Sittingbourne Kent ME9 9QW Lead Inspector Sarah Montgomery Unannounced Inspection 29th March 2007 09:00a Insight DS0000023966.V358713.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 Insight DS0000023966.V358713.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. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Insight Address 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) Brusons 5 London Road Teynham Sittingbourne Kent ME9 9QW 01795 521122 01795 520290 adamcinsight@aol.com Mrs Lynda Jane Cashford Mrs Javqueline Frances Hales vacant Mrs Lynda Jane Cashford Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Insight DS0000023966.V358713.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: Insight Brusons is care home providing care for 11 adults who have a learning disability and present challenging behaviours. The home is part of the Insight group of care homes. It is located close to shops and other local amenities in a village setting. Accommodation is provided in 2 separate buildings. The main house is a large detached building that offers spacious communal accommodation and has 7 single bedrooms. A further 4 single bedrooms are provided in a detached bungalow located in the grounds of the larger house. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this inspection on March 29th 2007. evidence was gathered by speaking with residents, staff and management. Several key documents were inspected. All outcomes were assessed as being excellent. What the service does well: 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. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 6 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 Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 7 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): Standard 2. Quality in this outcome area is excellent. Prospective residents benefit from having their individual aspirations and needs fully assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Assessment documentation for a recently admitted resident was inspected. As with their sister homes, assessment of prospective residents is a thorough and professional process, involving gathering detailed information from a range of other professionals, family and significant friends. It is only when the entire assessment has taken place, and information in it fully considered, that decisions are reached regarding the suitability of the placement. The assessment inspected contained evidence of the detail described above. In addition, with each area of assessed need, the home has recorded how they will meet that need, and has further anticipated any initial difficulties the resident may encounter given the extra demands a new environment and new people will place on them. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 8 Based on the findings from the assessment, guidelines and strategies for the staff team are developed, as are initial care plans and risk assessments. There are clear indications of continual review of the assessment. This home exceeds the minimum standards for assessment of prospective residents, and has developed an assessment process that demonstrates excellence in care provision. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is excellent. Residents can be confident that their individual changing needs and personal goals are reflected in their individual plans, and that the staff team will guide and support them to make positive decisions about their needs and choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In assessing these standards, care plans, individual reviews and risk assessments were inspected, and discussions were held with residents, management and staff members. Detail recorded within care plans and risk assessments demonstrated a clear link to initial and ongoing assessment. Objectives in both care and risk assessments were based on positive outcomes. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 10 Care plans and risk assessments were not static documents. It was clear that they are responsive to current need, be that daily, weekly or monthly, and that changes are made in respect of current need, in consultation and communication with individual residents. Review documentation clearly confirmed that residents make decisions about their lifestyle choices, with the text indicating that decisions by residents are made throughout the year, and not just at reviews. Residents who spoke with the inspector confirmed that they make decisions about their lives, and support and guidance from the staff team assist them in making decisions, especially difficult decisions. Discussion with staff, coupled with observation of working practice, evidenced not just a knowledge of individual care plans and risk assessments, but of a method of working together consistently and communicating with each other and with residents to ensure good team work and positive outcomes for all. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15 and 16. Quality in this outcome area is excellent. Residents are supported to make positive lifestyle choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Speaking with residents, management and staff, as well as reading daily records, care plans and review documentation, all evidenced that this home is committed to ensuring and promoting the individual’s right to live an ordinary and meaningful life, both in the home and in the community, and enables the residents to achieve their goals, follow their interests and be integrated into community life and leisure activities. On the day of inspection several residents were out. Many residents were coming and going, and some residents were enjoying activities at the home. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 12 The inspector spoke with three residents about their daily lives, and they described a varied mix of activity and opportunity, both home and community based, which covered their leisure, social and educational interests, as well as including participating in chores necessary to run the home. Residents and staff were enthusiastic and motivated when describing their typical week. It is evident that the work underpinning the success of supporting people to lead their lives is key to providing a service that meets people’s needs. Because the service is successful, and because residents are fulfilled and motivated, it is sometimes easy for a visitor to forget that this is a home for adults with challenging behaviours. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 13 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): Standards 18, 19 and 20. Quality in this outcome area is excellent. Resident’s benefit from having all of their personal and healthcare support needs met in accordance with individual assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents have an individual health care record. This record is a detailed document of historical and ongoing health/medical concerns, and provides information and guidance regarding specific health needs. As part of the initial assessment, the home undertakes a ‘health check’ on all new residents. This adds to and complements the health care record, and includes a summary for further action. The home promotes healthy living to all residents, and offers advice and information on how to achieve this. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 14 Health care plans also detail individual needs and preferences regarding how they receive personal support. Staff members spoken with demonstrated knowledge, sensitivity and respect when talking about meeting individual needs. The home employs a behavioural therapist, and accesses many community resources for mental health, epilepsy and speech and language. Individual health care plans inspected all clearly evidenced input from professionals. These included behavioural guidelines and individual protocols for epilepsy. Medication records were inspected. All records were stored and signed for correctly, and included a photograph of the individual resident as well as specific guidance on how the individual prefers to take their medication. Ten staff members have received accredited training in administering medication. Insight DS0000023966.V358713.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is excellent. Residents can be assured their views are listened to and acted upon, and that they will be protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector spoke individually to two residents about complaints and about feeling safe. Both residents spoke enthusiastically about the home and the staff team. Neither could think of anything they were unhappy with, but knew who to talk to if they had a complaint or felt unhappy about something. This is a home for adults with learning disabilities and challenging behaviours. Occasionally there are incidents at the home. The inspector asked the residents how they felt when things happened. Both residents said they felt safe at the home, and they were not scared of other people that lived there. They indicated that staff helped them feel safe, and that if incidents did happen, then things were sorted out quickly, and most of the time no one got upset. Staff reiterated that this was the case. When challenging incidents occur, there are set guidelines that are followed. These guidelines are prescriptive with Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 16 regard to the individual displaying challenging behaviour, and prescriptive regarding staff response to other residents including keeping them safe. All staff receive training in control and restraint, as well as training in adult protection. Staff spoke competently about their knowledge and working practice with regard to the protection of residents. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 17 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): Standards 24 and 30. Quality in this outcome area is excellent. Residents live in a comfortable, clean and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector spent a lot of time in communal areas talking with residents. It was clear that the residents feel at home, and that the furniture and décor are comfortable and homely. The physical environment of the home is appropriate to the needs of the residents. Much thought has been put into making the environment safe, while at the same time homely and comfortable. This has been achieved, and continual maintenance ensures that residents live in a pleasant, comfortable and safe home. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 18 Some bedrooms were inspected and these were decorated in accordance to individual wishes, and were comfortable and homely. All areas of the home inspected were clean and hygienic. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 19 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): Standards 32, 34 and 35. Quality in this outcome area is excellent. Resident’s benefit from being support by staff who are competent, enthusiastic, and trained. Residents are protected by the home’s robust recruitment policy and practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Management at the home invest in their staff team. All staff are encouraged to obtain certificated training, and the majority of the staff team are qualified in NVQ. All staff receive mandatory training in induction, Nappi, first aid, food hygiene, fire safety, manual handling, infection control, POVA, epilepsy, autism and behaviour management. Staff were observed throughout the inspection. The whole team displayed a confidence and competence that can only come from being well trained, and by Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 20 working consistently as a team. There was mutual respect between staff and residents, and an atmosphere of support and encouragement was present. Some staff were spoken with individually. They all said they enjoyed working at the home, said they felt the residents have a good quality of life, and that there is good teamwork. A selection of staff files were inspected. All files contained the correct information and evidenced that a robust recruitment procedure was followed. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 21 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): Standards 37, 39 and 42. Quality in this outcome area is excellent. Resident’s benefit from living in a well run home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All outcome areas and individual standards within these outcome areas have been assessed as ‘excellent’ and as exceeding minimum standards. This achievement has been possible by the home meeting the needs of each individual resident in each individual assessed outcome area. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 22 Management of this home is excellent. The home has a sustained track record for delivering good services to residents, and a good work environment for staff. The management style and approach is strong, and staff and residents see a clear leader who shapes the home with innovative practice and professional conduct. It was apparent that staff find the whole management team approachable, and that the views of the staff team and residents are not only listened to, by are welcomed and encouraged. This home continues to move forward by ensuring that residents views and needs underpin service delivery, and that residents are kept safe by following and updating policy and procedures which protect the health, safety and welfare of residents. Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 23 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 4 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 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 4 X X 4 X Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 24 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. Refer to Standard Good Practice Recommendations Insight DS0000023966.V358713.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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. 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