Inspection on 07/03/07 for Insight Walderslade

This inspection was carried out on 7th March 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

Insight Walderslade 06/03/08

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 Sarah Montgomery Key Unannounced Inspection 7th March 2007 09:30 Insight Walderslade DS0000068080.V331378.R02.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.V331378.R02.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.V331378.R02.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 669664 01630 869273 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.V331378.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection Brief Description of the Service: Insight Walderslade is a home providing 24-hour care and support to 6 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. Accommodation comprises of 6 single bedrooms, there is a dining room a lounge and kitchen. There are pleasant gardens to the front and rear of the property and there are ample parking facilities provided. The statement of purpose and service user guide is kept in the office. All service users are given a copy of the service user guide. The weekly fees are £1913.87. Insight Walderslade DS0000068080.V331378.R02.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 7th and 9th 2007. Evidence was gathered by speaking with the manager, staff team and residents, and by inspection of documents and policies. All residents were at home, and contributed to the inspection. Discussions with residents and staff, reading of care plans, and inspection of policies and individual records, all evidenced that this home is committed to promoting and practicing equality and diversity for all service users and staff. Outcomes for service users are positive, and all information gathered evidences that service users living at this home are leading valued and fulfilling lives. What the service does well: What has improved since the last inspection? What they could do better: The home should consider undertaking staff training in service users rights, and in dignity and respect. The home should consider having a summary of individual care plans at the front of care plan files for quick reference purposes. The home must ensure that two written references are received prior to commencement of employment. Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 6 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.V331378.R02.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.V331378.R02.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): 2 and 3. Quality in this outcome area is good. Prospective service users can be confident that their individual needs and aspirations will be assessed and met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This care home opened in September 2006. Four service users currently live at the home. Two of the service users transferred from another home within the Insight group, and two were new referrals. We looked at the assessment process for all four service users, and inspected in detail the assessment process for an individual referred by social services. The assessment documentation viewed evidenced a thorough full needs assessment had been undertaken. The service user was supported by their care manager to be involved in the assessment, and their views, aspirations and wishes were listened to and acted upon regarding the care, support and services available in the prospective home. Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 9 In addition, evidence and information was gathered from all professionals currently involved in providing care and support to the service user, and views from the family were sought. A joint assessment was also undertaken. The service user had several opportunities to visit the home and meet the staff team. The completed assessment outlined all identified needs, wishes and aspirations, and provided a service response to each area. It was clear from talking with the service user, that they felt supported and cared for by the staff team. The assessment had provided the team with knowledge and a baseline for providing the correct care and support to this service user. Documents read (care plans, risk assessments, behaviour plans) all evidenced that the detailed assessment has ensured that the service user receives care and support, which is individual and meets their needs. Insight Walderslade DS0000068080.V331378.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is good. Service users are supported and enabled to plan and make decisions about their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a very strong ethos on enabling residents to take control of their lives. Care plans viewed evidenced clear involvement of the service user, and a clear correlation between the needs assessment and outcomes identified in the care planning process. Service users are supported to develop their care planning further by working on a person centred plan. The home has demonstrated a commitment to ensuring service users personal history, their likes and dislikes, their hopes and Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 11 dreams, have been captivated by accurate and sensitive recording in this document. Observations during the inspection evidenced that service users are consulted about day-to-day lifestyle choices. These included planning an activity and choices about what to eat. Service users told the inspector that they are listened to by staff and get to do things they enjoy. Risk assessments were inspected. These documents were thorough and contained detailed information regarding the management of risk. Risk assessments offered protection to service users while maintaining appropriate levels of choice and measured risk. Guidelines accompanying the risk assessments provided clear direction for staff, ensuring continuity in working practice and service delivery. Insight Walderslade DS0000068080.V331378.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. Service users are supported and enabled to make choices about their lifestyles. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Insight Walderslade is a specialist service designed for adults with learning difficulties who have been additionally assessed as having challenging behaviours. The staff team work intensively with service users, implementing behaviour management strategies, with the identified outcome being the service user becoming able to lead a lifestyle of their choice unhindered by restrictions their current behaviours may impose. Therefore, working alongside service users regarding their lifestyle choices is the defining aim of Insight Walderslade. Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 13 The home draws on clinical expertise from within its own staff group, and also works closely with psychology and psychiatry services. Care plans and risk assessments evidence that service users are guided and supported to make decisions about their lives. Service users are encouraged to recognise their strengths as well as needs, and are supported to link their strengths and needs to education, work and leisure activities. Service users spoke enthusiastically to the inspector about what they were doing, and displayed genuine insight into how living at the home, with all the support they have received, has changed their life and given them choices and opportunities that previously were not available to them. It was clear from talking to service users that their rights and responsibilities are recognised, and that staff spend time supporting and guiding them towards positive decisions and choices. Records demonstrated, and staff and service users confirmed, that links to family and friends remain strong. The home supports individuals to continue contact with friends and family, taking into account the wishes of the service user and of any history that may carry restrictions with contact. Service users are encouraged to take responsibility for leading a healthy lifestyle. To this aim, they are involved in planning and preparing meals and menus. Support for this is provided by staff and by a nutritionist, who looks at the menus and will offer comments and changes if required. Insight Walderslade DS0000068080.V331378.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. Service users can be confident that their personal and healthcare support needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans and assessment documentation were inspected. These documents provided clear information regarding individual’s personal support, physical and emotional health, and medication needs. This includes gathering information from a range of professionals, as well as ensuring that the wishes and views of residents are recorded and acted upon. This home specialises in supporting people who may have challenging behaviours. Meeting and understanding the emotional health needs of residents is paramount to achieving positive outcomes in terms of individual goals and the ethos of the home. To this aim, the Insight group employs a Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 15 behavioural therapist. He works with staff and service users, imputing on assessments, care plans, and developing behavioural strategies for individuals. Staff spoke competently to the inspector about how they support individual residents with regard to their emotional health. It was clear from talking with a number of staff that the team have a consistent approach towards individuals that is led by care plans and additional guidelines. Residents spoken with demonstrated insight into some difficulties that face them in their daily lives, and recognised that staff ‘help me to calm down’. Medication is stored appropriately and records were clear. Staff are trained to administer medication. The medication file contains notes on why the medication is prescribed with a list of any side effects. Guidelines for administering PRN medication are clear. Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 16 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. Quality in this outcome area is good. Service users can be confident their views will be listened to, and that they will be protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a clear complaints procedure that is written in accessible language. Service users have access to the procedure and clear guidance is provided regarding how and who to make a complaint to. The home has received no complaints. Discussion with the manager evidenced in depth knowledge on protection of vulnerable adults, and the home’s responsibility regarding reporting of concerns. The manager ensures the staff team are up to date on changes in policy and procedure regarding adult protection. The home has the multi agency adult protection procedures alongside their own policy. All staff have recently attended adult protection training. Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 17 Service users spoke confidently about making complaints. They stated staff listened them to, and that complaints were taken seriously and ‘something would be done’. Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 18 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, 26, 28 and 30. Quality in this outcome area is good. Service users live in a safe, well maintained and comfortable environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents live in a comfortable, well maintained, and homely environment. The home is decorated and furnished to a high standard throughout. All communal areas are accessible and safe. The communal areas comprise of a kitchen, a dining room and a lounge. There is a large landscaped garden that is accessible and safe. Service users bedrooms are decorated, furnished and accessorised according to individual residents tastes and wishes. Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 19 The home presented as clean. The manager and staff are vigilant about hygiene and have experience and knowledge of health and safety and infection control in a care home setting. Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 20 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, 33 and 34. Quality in this outcome area is adequate. Service users cannot be sure competent and effective staff always support them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff interactions with service users were observed over the course of the inspection and generally were found to be positive, with staff being approachable and motivated, and service users feeling listened to, their choices respected, and their care plans being followed. Incidents observed during the inspection highlighted shortfalls in staff competencies. During the inspection a staff member was heard using inappropriate language towards a service user, the content of which included a threat. This behaviour demonstrated a lack of regard and a disrespectful attitude. The manager was Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 21 made aware of the incident, and undertook to address it immediately with the member of staff. The layout of the home includes an upper level with a large landing area. The office is upstairs. It was observed during the inspection that staff would frequently call up to the office (or call down from the office) and conduct loud conversations. Given that on some service users care plans loud noise was an issue, the inspector spoke to the manager about efficient methods of communication between staff, which also enabled maintenance of a peaceful environment. The manager agreed to address this with all staff immediately. Four staff files were inspected. Three files contained correct documentation, in that there was an application form, references, a job description, a contract and a CRB. One file did not have any references, the application form was incomplete, and there were no interview notes. The manager agreed to follow this up immediately, and obtain written references. The manager informed the inspector of individual staff skills, qualifications and previous experience. It was clear from inspecting the rota that these qualities were balanced on each shift, and that consideration had been given to effective team work. Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 22 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, 39 and 42. Service users benefit from living in a well run home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although some shortfalls were identified during inspection, evidence gathered over the course of two days indicated that the manager is competent, motivated, professional and dedicated to ensuring best practice amongst the staff team, and developing a service whereby people living in the home are enabled to make real and positive choices about their lives, realise their aspirations, and plan for their futures. Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 23 Conversations with staff and residents demonstrated the home’s ingrained ethos of inclusion and consultation with residents. Residents spoke to the inspector about their day to day lives, and about how staff support decisions and choices they make by ensuring things are followed through. Examples of this are; maintaining contact with family, visiting friends, going to college, learning a new skill in the house, having time to talk to staff, making choices about holidays. The manager stated that residents, care managers, families and other stakeholders are consulted frequently by the home regarding quality assurance. The manager displayed in depth knowledge of the service user group, of individuals within that group, and of management skills required to manage a service, and skills needed to bring all the knowledge together to translate them into a home which people want to live in. The manager ensures her knowledge on care practices and current developments are up to date, by attending training courses and by keeping abreast of government, national and CSCI developments through research on the internet and through media. The home has robust health and safety procedures, and the Insight group has a good record of meeting health and safety requirements and legislation. During the inspection residents were asked general questions about health and safety. Their responses demonstrated they are aware of potential hazards in the home, and feel confident that the staff team will keep them safe. Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 24 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 “ ” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 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 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 2 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 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 3 X X 3 X Insight Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 25 NA 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 Walderslade DS0000068080.V331378.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local 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.V331378.R02.S.doc Version 5.2 Page 27 - 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. 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