Inspection on 12/10/05 for Insight - Eastchurch

This inspection was carried out on 12th October 2005.

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

Insight - Eastchurch 02/03/07

Insight - Eastchurch 23/02/06

Insight - Eastchurch 22/03/05

Insight - Eastchurch 26/01/05

Similar services:

Thorndene

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Greenacres

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

CARE HOME ADULTS 18-65 Insight - Eastchurch 83 High Street Eastchurch Sheerness Kent ME12 4DF Lead Inspector Christine Lawrence Announced 12 & 13 October 2005 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. Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Insight - Eastchurch Address 83 High Street, Eastchurch, Sheerness, Kent, ME12 4DF 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) 01795 880484 01795 880484 Jacqueline Hales N/A Registered Care Home 10 Category(ies) of Care Home for Younger Adults (18-65) with a registration, with number Learning Disability of places Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22/03/05 Brief Description of the Service: Insight Eastchurch is a home providing 24-hour care to 10 adults who have learning disabilities and additional challenging behaviours. It is owned by Mrs J Hales and Mrs L Cashford. Mrs J Hales and Mrs L Cashford own a second home providing for a similar client group. The home is located in the village of Eastchurch, on the Isle of Sheppey; it is close to all amenities and is on a bus route. Accommodation comprises of 10 single bedrooms, there is a large dining room and two lounges, one of which is a quiet room situated on the first floor. There are pleasant gardens to the front and rear of the property and there are ample parking facilities provided. Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out over two days. The inspector spoke to Jackie Hales and interviewed three members of staff. Eight relatives/visitors to the home completed comment cards and five residents were helped to complete comment cards also. The inspector undertook a tour of parts of the building, including (with their permission) some residents’ bedrooms. The inspector also looked at care plans and other records. 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. Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 2 Prospective residents, along with their representatives, have the information they need to decide if Insight is the right place for them. Residents have their wishes and needs assessed to ensure they can be met. EVIDENCE: The service user guide and the statement of purpose have recently been updated. They contain all the relevant information and are clearly set out. Although no new residents have been admitted for some time it is clear from the records that the process of assessing whether the home can meet someone’s needs is detailed and takes into account the needs and wishes of prospective residents as well as the existing group of people. Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 Page 8 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 and 9 Residents know that their needs and goals will be included in their individual plan and that they will be helped and supported to make decisions about their lives, including sometimes taking risks. EVIDENCE: The on going assessment and care planning process is very detailed and covers a wide range of subjects. The records are well maintained and are filed in differently named areas so staff can easily access the information they need. Care plans and residents’ needs are reviewed on a regular basis at 3 monthly and six monthly intervals. The home facilitates a key worker system to support residents to make choices and there is also an external facilitator for residents’ meetings (Client Forums). Decisions do sometimes have to be made on behalf of residents and to underpin this the home organises ‘best interest’ meetings which involve other professionals and family if appropriate. One visitor to the home included in the comment card “…excellent service, client centred, staff have a good understanding of service user needs…”. There is a policy in place regarding missing persons. The care plans contain detailed risk assessments. Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 Page 9 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) 12, 13, 15, 16 and 17 Residents take part in appropriate activities, including using local facilities. They are supported in their personal relationships and have their rights and responsibilities respected in their daily lives at the home. Residents are offered a healthy diet and encouraged to enjoy their food. EVIDENCE: There is a variety of activities, both social/recreational and educational available for residents. The records seen showed that this is very individual, according to needs and wishes. Staff described some of the things they do with residents. Community facilities are accessed. The inspector was informed that some residents are on first name terms with local shopkeepers. The residents who completed comment cards said they had “…lots of things to do…”. The home has its own transport and public transport or taxis can be accessed as required. Working weekends and evenings is a part of staff duties. Holidays also will be on an individual basis reflecting residents’ wishes and identified needs. All eight people who completed visitors’ comment cards for this inspection said that they were made welcome when they visited and that there was no Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 Page 10 restriction on times. There is a Visitors Policy in place and there is provision for people to receive their visitors in private if appropriate. Where there are any particular conditions about visitors this is contained within the care plan and is based on discussions with others involved in the care of an individual. Staff explained that residents either express their own wishes and preferences regarding food or their likes and dislikes are known and responded to. Residents can choose where to eat although this will be based on a risk assessment for that individual. Some residents are encouraged to get involved with food preparation or making drinks but this is very much based on individual abilities and risk assessments. Residents’ nutritional needs are assessed within their individual care plans and the home can respond to special needs such as weight gain/loss, diabetes. There is a Food and Nutrition policy in place. Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 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 and 19 Residents’ wishes regarding personal care and support are responded to. Physical and emotional needs are identified to ensure that they are met. EVIDENCE: Staff spoken to during this inspection confirmed that the overall philosophy of the home is one which values and respects individuals living there. Understanding residents’ particular and very individual needs, underpinned by clear risk assessments was highlighted by staff. It is clear from talking to some residents that they are encouraged to express preferences about their daily routines. Where residents are limited in their ability to communicate preferences staff said that care plans would be referred to and it was therefore important to make sure that clear information was shared with colleagues. Staff meetings would also be used for this purpose. Consistency of support offered is also managed through the keyworker system in place at the home. A Communication Book as well as careful planning for each shift (allocations sheet) underpins the ethos of providing care and support appropriate to the individual. A document entitled The Insight Health Check is used to assess and monitor residents’ health care needs. Alongside the detailed assessment and care planning process this ensures that residents’ needs are monitored and responded to. Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 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 standard(s) 22 and 23 Residents can be confident that their views will be listened to and responded to. The policies, procedures and practices ensure that residents are protected from abuse. EVIDENCE: There is an appropriate complaints procedure in place and information about how to make a complaint is included within the service user guide. Information about how to contact the Commission for Social Care Inspection is also available. Residents who completed comment cards all said that there are meetings to talk about what’s good and what should be changed in the home. These meetings are facilitated by an external organisation. The key worker system supports residents in having their views listened to. Policies and procedures are in place regarding residents’ finances and storage of money/valuables is satisfactory. Physical intervention may form part of the management of an individual’s behaviour. There are very clear, detailed guidelines about how this is undertaken. The home involves other professionals in deciding any planned intervention. There are policies and procedure relating to adult protection, including whistle blowing, and the home has a designated in-house adult protection trainer. Three members of care staff were spoken to during this inspection. They were all clear about their responsibilities regarding keeping residents safe. Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 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 standard(s) 24, 25 and 30 Communal and individual rooms suit residents’ needs and lifestyles in a safe way. Residents benefit from living in a home which is clean and hygienic. EVIDENCE: Insight, Eastchurch is situated in the middle of a village with all of it facilities. The building is suitable for its stated purpose and staff work hard to keep things as homely as possible. There is some limitation on ornaments and plants etc in communal areas due to some individuals’ behaviour but it is very clear that residents own rooms are seen very much as their own space, with very individual style of furnishings and décor. The rooms in the home are all single and two residents particularly commented on their rooms as being one of the good things about living there. There are no outstanding requirements from the fire safety officer or the local authority environmental health officer. The home was clean and free from offensive odours at the time of the inspection. The laundry facilities are appropriate and the home ensures that equipment is up to date by having a lease contract. There are policies and procedures in place regarding infection control and the Control of Substances Hazardous to Health (COSHH) Regulations and staff confirmed that protective clothing (gloves etc) is available as required. Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Staff are appropriately trained, ensuring that residents’ individual and joint needs can be met. EVIDENCE: There is a training programme for staff which includes administration of medication, protection of vulnerable adults, epilepsy, autism, Makaton, NAPPI training and national vocational qualifications. There is also induction training. Staff members have core training that must be undertaken and other courses which are identified within the supervision/appraisal process in the home. Staff spoken to said they were offered opportunities for training. Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 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 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 and 42 Residents benefit from the home being managed by someone who is competent, experienced and knowledgeable. Policies, procedures and practices ensure that residents’ health, safety and welfare are promoted and protected. EVIDENCE: Lynda Hales takes day-to-day responsibility for Insight, Eastchurch. She has a nursing background (RNMH) and other qualifications include the Diploma in Counselling, Behaviour Therapy in Learning Disability, Community Learning Disability and Psychiatric Nursing and Teaching and Assessment in Clinical Practice. She is also currently completing a Registered Manager’s Award. The following subjects are included in the planned training for all staff:manual handling, food hygiene, fire awareness, manual handling and infection control. Dates have been set for staff who have not yet received this training. A spot check on maintenance and service contracts showed that these are appropriate and up to date. There are policies and procedures relating to health and safety. Fire safety checks are undertaken and recorded. Accident Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 Page 16 recording is compliant with the Data Protection Act. Staff spoken to confirmed that training regarding health and safety is either planned or has been undertaken. They also expressed confidence that management responds when maintenance is required for things like broken furniture etc. Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 Page 17 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Insight - Eastchurch Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 Page 18 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 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 Good Practice Recommendations Insight - Eastchurch H56-H05 S23965 Insight Eastchurch V244632 121005 Stage 2.doc Version 1.40 Page 19 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. 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