Inspection on 06/03/08 for Insight Walderslade

This inspection was carried out on 6th March 2008.

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 Walderslade 07/03/07

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 Walderslade 73 Robin Hood Lane Walderslade Chatham Kent ME5 9NP Lead Inspector Elizabeth Baker Unannounced Inspection 6 March 2008 09:40 Insight Walderslade DS0000068080.V359367.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 Walderslade DS0000068080.V359367.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 Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Insight Walderslade Address 73 Robin Hood Lane Walderslade Chatham Kent ME5 9NP 01634 869273 01634 869273 Llusher99@aol.com 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) Mrs Jacqueline Frances Hales Mrs Lynda Jane Cashford Lauren Kay Usher Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th March 2007 Brief Description of the Service: Insight Walderslade is a home providing 24-hour care and support to six adults who have learning disabilities and additional challenging behaviours. It is one of a group of three homes owned by Mrs J Hales and Mrs L Cashford. The home is located near the village of Walderslade. It is close to all amenities and is on a bus route. Bedroom accommodation for service users comprises three single bedrooms on the first floor and three single bedrooms on the ground floor. All bedrooms have ensuite washbasin and toilet facilities and one has shower facilities. There is a dining room, lounge and kitchen. There are pleasant gardens to the front and rear of the property and there are ample parking facilities provided. Fees currently range from £1913.87 to £2,674.35 per week inclusive. Current activities include visits to cinemas, swimming pool, libraries, church services and pubs. Holidays and internal entertainment such as aromatherapy and music sessions are also available. A copy of the latest report is available on request at the home. Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means people who use this service experience excellent quality outcomes. This is the key unannounced visit to the home for the inspection period 2007/08. Allocated inspector Elizabeth Baker carried out the visit on 6 March 2008. The visit lasted just over six hours. As well as briefly touring the home, the visit consisted of talking with some service users and members of staff. One of the service users and one member of staff were interviewed in private. Feedback was provided to the home manager during and at the end of the visit. The inspector also briefly met both providers. At the time of compiling the report, in support of the visit, the Commission received survey forms about the service from one relative and two health care professionals. Subsequent surveys have been received from one service user, one care manager, two healthcare professionals and one relative. At the Commission’s request the home manger completed and returned the home’s first Annual Quality Assurance Assessment (AQAA). Some of the information gathered from these sources has been incorporated into the report. The home continues to run at full occupancy. We have not received any complaints about the service. What the service does well: The home manager is receptive to advice and suggestions made, and demonstrates an eagerness to rectify any matters, which may require attention. The home provides a homely place for the residents to live in. Residents are encouraged and enabled to be as independent as is possible, within the confines of agreed limitations and boundaries. Comment card responses received prior to the visit included “the Insight Care Home does everything possible for [relative’s] needs and welfare”; “the home offers care and support for challenging clients, with warmth and creativity, while also providing appropriate boundaries”; “an excellent placement”. Comment card responses subsequently received indicated the service does well in “Managing very complex care needs, reports situations which occur and the action taken, flexible with providing and responding to care needs and supporting and keeping families informed”. Insight Walderslade DS0000068080.V359367.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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 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 Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Residents who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Comprehensive information and a robust pre admission process assist prospective service users and their advocates in determining the suitability of this home for their individual assessed needs. EVIDENCE: There is a statement of purpose and service user’s guide in place. The documents provide good information. The service user guide provides detailed information about this particular home and the Statement of Purpose contains information about this home and the other two homes within the group. There is a good system of ensuring prospective service users are suitably placed at the home. This includes assessing prospective service users in their current place of residence. The information gathered during the process is used to inform the resultant care plan. When a decision of admission is finally made, the new service user is provided with a contract setting out the terms and conditions of staying at the home. This is in addition to the contract the home has with the sponsoring authority. Insight Walderslade DS0000068080.V359367.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): 6, 7 and 9. Residents who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Service users are enabled and supported in living an independent life as is possible. EVIDENCE: The service user files inspected contained care plans, shift logs, communication contacts, activities records and other supporting documents. Care reviews undertaken with input from individual care managers are normally carried out on a six monthly basis. The service user and or their advocate are invited to attend these reviews. To supplement these, in-house reviews are undertaken on all service users on a fortnightly basis. This includes input from a behaviour therapist. Assessments seen contained good evidence that any restrictions placed on service users for routine activities had been done so after the risks associated to that particular service user had been considered with proper regard to their safety. Where restrictions are applied, service users are made fully aware Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 10 why the action has been taken and are then involved with care professionals and staff to improve the situation. All service users at the home are encouraged to lead as independent life as possible. Three of the service users attend Adult Education one day a week. And another service user attends a specific class with a number of service users from other homes within the group, to increase their independent living skills. At the visit a service user spoken with described how they enjoy going out every day to buy a newspaper and soft drink in the village. And another resident was being supported to go on a shopping trip. Insight Walderslade DS0000068080.V359367.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): 12, 13, 15, 16 and 17. Residents who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Links with the community are good and support and enrich residents’ social, occupation and development opportunities. Service users benefit from a variety of lifestyle choices and with appropriate staff support where needed. EVIDENCE: To promote diversity and equality the home supports service users in developing their skills and abilities, including continued learning if that is their wish. However if a resident does not choose to do this, their wish is respected. To maximise independence service users are supported in managing their own finances and benefits. Indeed one resident is doing this. The home does not manage personal monies for any of the residents. However arrangements are in place, which enable services users receiving cash if they require it for any purpose. Records of the arrangement are maintained and audited. Advocates would then be invoiced in respect of the amounts involved for reimbursement purposes. Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 12 Service users are supported in making home visits and one resident said it is important for them to keep in touch with family and friends out of county. Where possible service users are assisted in taking holidays. These have included places such as Brighton and London. One service user has expressed a wish to go to Disney in Paris and staff are taking steps to prepare the service user for taking such a trip, including taking small breaks in unfamiliar places but in England. A number of service users like to attend religious services and go to Church on a regular basis. Arrangements are in place for service users to vote at elections if they wish to. To promote privacy all bedroom doors are lockable. A resident spoken with said they are given their post and can make telephone calls to family and friends if they want to. Service users spoke openly throughout the visit in the presence of staff. A comment card respondent commented about the home’s privacy and dignity practices in that they had never had cause for concern and see high practice there, as standard. Residents spoken with indicated they enjoyed their meals. Menus are composed with input from service users with regards to their likes and dislikes. A specialist then reviews the proposed menus to ensure meals are nutritionally balanced. Insight Walderslade DS0000068080.V359367.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): 18, 19 and 20. Residents who use the service experience excellent outcomes. This judgement has been made using a range of evidence including a site visit to this service. Residents receive personal and health care support in accordance with their needs, wishes and preferences. EVIDENCE: Staff provide help and support service users as per their individual assessed needs, as well as providing encouragement and explanation as appropriate. During this visit an unexpected health incident was handled in a re-assuring and calm manner, reducing the service user’s anxiety. A survey respondent recorded the care home sees that contact with the family is encouraged by way of regular visits, telephone contacts and letters. And that their relative is always assisted with personal hygiene needs by a carer of the same gender. All residents are registered with a GP and service users have access to other healthcare specialists including dentists, opticians, psychiatrists and behaviour therapists. Service users were seen appropriately dressed and groomed for the time of day and season, with attention to detail where this is important to them. Service users are supported in attending well person clinics so their health is regularly checked and monitored. Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 14 All service users take prescribed medication. Records are kept when medicines are administered. Those inspected provided good information and audit trails. Records for administer when required medicines (PRN) are excellent and provides staff with detailed information of when to administer or not. The home has recently commenced on obtaining more information on service users’ spiritual and cultural preferences and wishes in the event of death and dying. Having this vital care information readily available is good practice, particularly at a sensitive time. Insight Walderslade DS0000068080.V359367.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): 22 and 23. Residents who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Residents can be sure any issues and concerns are listened to and acted upon. EVIDENCE: The returned AQAA document indicates the home has not received any complaints about the service in the last 12 months. The Commission has not received any complaints about the service. The member of staff interviewed said they had received Protection of Vulnerable Adults training and described appropriately the action they would take if they suspected abuse having taken place. The home has a copy of the county’s multi-agency Adult Protection policies and procedures. The service user guide informs service users what to do if they have a complaint. The Commission’s contact details are included. Insight Walderslade DS0000068080.V359367.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Residents who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Service users live in a homely and comfortable environment. EVIDENCE: The home is a converted private house, situated close to the village of Walderslade, is typical of the surrounding area and there is nothing to determine this is anything other than a family home. The premises are kept in a good decorative state both internally and externally. As part of the home’s ongoing redecoration programme, the lounge and a resident’s bedroom are about to be redecorated. Areas inspected were clean, warm and odour free. The home does not have a designated laundry room. The domestic type washing machine and dryer are situated in the kitchen requiring dirty laundry to be taken through a clean area. At the time of arrival a number of overflowing bins were situated in the hall area outside the kitchen containing either dirty or clean linen. Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 17 Until recently all service users have been continent. However due to a specific situation there are now occasions when soiled laundry is generated and requires disinfection washing. To do this the soiled laundry is transported to one of the other homes within the group, which has the appropriate facilities. Whilst recognising the situation may only be temporary, to maximise infection control practices and facilities the home should consider the provision of a dedicated laundry facility for the future. As is good practice the home has an infection control policy and procedure. However it was identified on this visit that the home does not have a copy of the guidelines published specifically for care homes by the Kent Health Protection Unit. Contact details were provided to the manager. Having a current copy of these guidelines may assist the home in developing current infection control policies further, particularly if any of the residents require more personal hygiene support in the future. Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 18 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): 32, 34 and 35. Residents who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Residents’ care, social and emotional needs are promoted by a stable workforce in such numbers that meet their needs. EVIDENCE: Over 50 of the care staff team have achieved NVQ level 2 care qualifications or above and further staff have been enrolled on this course. Staff spoken with had a good understanding of the needs of the service users. Handover time is provided so staff can discuss important changes, which affect residents’ behaviours, wellbeing and general care. The care records inspected provided good information on the support and encouragement staff need to know to assist service users in their daily living activities. A training matrix is maintained and a copy was provided to support this visit. This indicated some staff having received training in subjects including breakaway techniques, first aid, food hygiene, fire awareness, manual handling, administration of medication, POVA, epilepsy, autism and restraint. The manager and a number of support staff will be attending Mental Capacity Act awareness training in April 2008. Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 19 Two personnel files were inspected. Evidence was seen that the home seeks and obtains references and requires staff to apply for Criminal Record Bureau clearance. New applicants are required to complete an application form. However the form requires applicants to record employment histories for the last 10 years only. Regulation 19(1)(b) Schedule 2 now requires that a full employment history be stated, with evidence that any unexplained gaps have been investigated. As the home manager is eager to fully comply with this regulation it was suggested she accesses the Commission’s website to obtain a copy of the two InFocus documents issued in 2006, and published to assist services in the development of recruitment procedures and practices. The documents in question are called Safe and Sound? Checking the suitability of new care staff in regulated social care services and Better safe than sorry – Improving the system that safeguards adults living in care homes. Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 20 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): 37, 38, 39 and 42. Residents who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Residents have the benefit of living in a home, which is managed by an enthusiastic home manager. EVIDENCE: The home manager has run the home since September 2006, possesses the knowledge and experience of the home to fulfil her role and is expected to satisfactorily complete her Registered Managers Award (RMA) course in a few weeks time. The home manager keeps her skills up to date by attending training courses appropriate to her role, including train the trainer courses for subjects including food hygiene, moving and handling, infection control and Protection of Vulnerable Adults facilitated by Kent County Council. Once the manager has completed the RMA course she intends to obtain a Certificate in Education qualification. Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 21 Meetings are held so residents and staff can voice their opinions and make suggestions about how the service is run. Inspection reports are available on request. Service users are encouraged to express their choices on a daily basis to staff. The home’s quality assurance programme includes looking at residents’ achievements and goals for the future. Regular team meetings are held whereby staff can focus on resident’s current and future needs. Good rapport was observed between service users and staff. The returned AQAA indicates that policies and procedures are regularly reviewed and updated. This should help staff in ensuring they provide appropriate care and support in line with current good practice and legislation. All six residents are fully mobile so lifting and moving equipment is not currently required. The returned AQAA indicates that the home’s equipment is serviced and maintained as recommended by the manufacturer or other regulatory body. At the time of the home’s registration in 2006, an Environmental Health Officer and Fire Safety Officer made visits to the home. The home was found to be satisfactory, for their respective requirements. Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 22 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 3 2 4 3 X 4 X 5 3 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 3 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 4 3 4 X 3 3 3 X X 3 X Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 23 NO 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 2 Refer to Standard YA30 YA34 Good Practice Recommendations It is strongly recommended that a designated laundry is provided in the future, to minimise infection control risks to both service users and staff The application form must be amended to ensure applicants state full employment histories Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI Insight Walderslade DS0000068080.V359367.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!