Inspection on 29/06/05 for Kanner Project (Wixenford)

This inspection was carried out on 29th June 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kanner Project (Wixenford) 27/11/07

Kanner Project (Wixenford) 27/08/06

Kanner Project (Wixenford) 16/02/06

Kanner Project (Wixenford) 02/11/04

Kanner Project (Wixenford) 29/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Kanner Project (Wixenford) Wixenford House Colesdown Hill Plymouth PL9 8AA Lead Inspector Tina Maddison Announced 29 June 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. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kanner Project (Wixenford) Address Wixenford House, Colesdown Hill, Plymouth, Devon, PL9 8AA 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) 01752 895094 Small House Homes Ltd Mrs Clare Denise Lowther Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2005 Brief Description of the Service: Kanner is operated by Small House Homes Ltd who own a number of care homes around the Plymouth area. The property is a large detatched house that is set in its own grounds near the town of Plymstock. Kanner project is registered to provide care and accommodation to five young people under the category of Learning Disability. Service users may also present behaviours that challenge services. Service users have their own lockable area of the house that includes a bedroom, lounge and bathroom facilities. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection started at 0945. A pre inspection questionnaire was received from the Registered Manager. Two feedback cards were received from relatives. The current service users are unable to articulate any opinions regarding the care in the home. A meal time was observed and a tour of the home was conducted. What the service does well: What has improved since the last inspection? What they could do better: The environment could be improved and the house is in need of refurbishment in some areas. There is no maintenance and refurbishment plan. The gardens Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 6 could be enhanced to provide a stimulating and interesting area for the residents. The quality assurance system needs to be developed. Portable appliance testing needs to be implemented. 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. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5. The homes statement of purpose and service users guide provide prospective service users and their families with details of the services the home provides, enabling an informed decision about admission to the home. EVIDENCE: The home has produced a comprehensive service users guide and statement of purpose. These documents have been produced in widget form to aid the service users understanding of these documents. Full pre admission assessments were on file for each service user, and a pre admission procedure will vary depending on the individual needs of the prospective service user. Discussion with service users families and health and social care professionals is undertaken prior to identification of a potential placement. Most of the service users at the home have come from differing areas of the country and the home has liaised with different social services departments who have different assessment requirements. Each young person under the age of 18 years has a placement plan setting out assessed needs, objectives of the placement, and how these are met on a day to day basis. Documents stating terms and conditions of a placement in the home, and individual contracts were not available for inspection in the home, and the Manager was unclear regarding exactly what service users could expect to be provided in the home as part of the contract price, and what the individual service user is expected to fund themselves. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,10. Residents individual needs and choices are understood by staff, and independence and risks are appropriately balanced. EVIDENCE: The home has comprehensive service user plans for each resident that include details of all planned interventions and interactions and are specifically goal oriented. Details of how behaviours and risks will be managed are detailed and comprehensive. Each outing staff undertake with a resident is risk assessed. Residents individual methods of communication are understood by staff, despite their verbal communication being limited. Residents are encouraged to participate in the day to day running of the home, and regularly join staff in the cleaning of the house and doing their own laundry. One resident really enjoys vacuuming his room, and one enjoys growing tomatoes in the garden. Each residents individual area of the house is lockable, and doors are alarmed. This has been agreed with individual care managers and families. Restraint is only used as a last option to prevent harm to a resident or another person, and details of restraint interventions are clearly contained in care plans. Staff are highly trained in restraint and control interventions. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 10 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) 11,12,13,14,15,16,17 Service users rights are respected and some appropriate leisure activities are provided inside and outside of the home. Dietary needs of residents are well catered for and a varied selection of food is available that meets residents tastes and choices. EVIDENCE: The Manager could provide documentary evidence that residents families are actively encouraged to be a part of the residents life. The organisation provides a house in Plymouth where families can stay if they are visiting from outside of the area. The organisation also provides a school where the young people are able to attend to further their skills in a variety of areas. An independent advocate has been sought to support one resident who does not have family input. Staff communicate individual daily activity programmes to residents using a picture board that shows all daily activities planned, and when the activity is completed the picture is moved to the bottom of the board to be clear that the activity has finished. Holidays are carefully planned and risk assessed, and all residents enjoy holidays or day trips. Most of the residents Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 11 have their own vehicles or have use of the homes vehicles. The home has a vacancy for a cook at present, and therefore staff currently undertake the cooking of meals. There is a planned menu, reviewed regularly, and staff were seen to eat meals alongside service users, sensitively supporting them to make choices regarding food. The Manager has plans to make the dining area a dedicated area for eating meals, as currently is doubles as a dining room and an activity area, and this dual use may be too confusing for the residents who have autism, and could create distress as a result of this confusion. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 12 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) 18,19,20 Residents can be confident that their health and personal care needs will be met. The medication at this home is well managed promoting good health. EVIDENCE: Residents have individual accommodation that includes a lounge, bedroom and bathroom facilities. Communal areas are available downstairs, but residents have limited interactions and most prefer their own space. It was evident on the day of the inspection that staff do respect the privacy and dignity of the residents and interacted with them in a sensitive and enabling manner. Residents are registered with local GPs, and the home has links to the learning disability services in Plymouth, and associated health professionals for both physical and emotional support for residents. A keyworker system is in operation in the home. None of the current residents are able to self medicate. The medication system was found to be robust and well managed. Records regarding medication were found to be accurate. Medication is securely stored. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 13 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) 22,23 Management and staff have a good working knowledge and understanding of adult and child protection issues that protects residents from abuse. EVIDENCE: The home has a complaints policy and procedure that is available in a format accessible to residents, however the current service users would need a great deal of support from family or advocates to use the procedures. No complaints have been received since the last inspection. The current residents at the home have a high level of challenging behaviour, and there is potential for physical aggression towards staff. All staff have received training in physical interventions, that could be seen during the course of the inspection. Staff have received training in non physical interventions, de escalation and breakaway techniques. All physical interventions are recorded. Staff have also received training in child protection and the home has a policy on bullying and a copy of the ACPC handbook. There is also a policy and procedure for child protection. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 14 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) 24,25,26,27,28,29,30 Generally the environment at Kanner is a comfortable and pleasant place to live for the service users. A planned programme of maintenance and improvement would improve the house and ensure a safe environment for the service users. EVIDENCE: The property is a large detached building that offers opportunities for residents to have their own space. The home is lockable and alarmed in some areas and this has been agreed with families and care managers to ensure that residents needs can be met safely. A staff intercom is also in place. The home currently does not have a planned maintenance programme, and there are areas of the building that need attention. In particular the front path that is uneven and has holes that need repairing. The front path has a wooden handrail leading to the front door, and this must be replaced, as it has rotted and is splintering. The residents living areas have been decorated by staff to reflect the residents personal interests and tastes. One bed base should be replaced. There are large grounds surrounding the house, and more could be done to make these grounds of interest, attractive and accessible to the residents, as they do spend a good deal of time at the home due to their needs, as there is a limited Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 15 amount of activities that can be undertaken outside of the home. There is a swimming pool, but it is in need of repair. Some bedrooms are very plain, due to the destructive behaviour of the residents. This is managed appropriately. The home has a sensory room on the first floor that is enjoyed by the residents. Staff undertake cleaning as part of their duties, and it was noted that the home was spotlessly clean, and was warm and well lit. It is recommended that one residents bedroom would benefit from an air conditioning provision, as the room faces south and is very warm, and staff reported that sometimes this heat causes distress to the resident concerned. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 16 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) 31,32,33,34,35,36 The staff have a good understanding of the residents complex support needs and are a well trained and well supervised group. Robust recruitment procedures are in place to ensure the protection of residents. EVIDENCE: Staff appeared to have a clear understanding of their roles and responsibilities. The home operates a high staffing ration due to the needs of the service users. There is normally eleven or twelve care staff on duty undertaking fourteen hour shifts from 8am –10pm. At night there are two night waking care staff plus two additional sleeping staff. Also on duty during the day are two senior care staff and a Manager. Staffing rotas were inspected. There are monthly key worker meetings, regular staff meetings and at least 50 of staff hold an NVQ3 in care. Staff files were seen, and were found to contain all the required records. The home has a recruitment procedure and policy that is overseen by the head office. Staff are now given a staff handbook upon commencement of employment, and a thorough induction period is given to new employees. The organisation offers a range of training at their centre, and there is a training budget and training programme. Procedures are in place for dealing with physical aggression towards staff. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 17 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) 37,38,39,41,42. There is strong and positive leadership in the home. Some areas of health and safety need to be addressed. EVIDENCE: The Registered Manager holds the Registered Managers Award, and now has the mentors award and WEA child protection. She has plans to undertake a diploma in autism. Mrs Lowther is suitably experienced and qualified to manage the home and can demonstrate an excellent understanding of the complex care needs of the current residents. The Manager continues to develop the quality assurance system for the home. The records viewed at this inspection were comprehensive, and well maintained. An understanding of health and safety for staff and risk assessment is a priority in the home. Staff have undertaken training in moving and handling, fire prevention, first aid and physical interventions. The home has not got automatic water temperature regulation fitted to each hot water outlet, but has water temperature set centrally on the main boiler. On the day of the inspection the water coming out of one residents basin in the bedroom was extremely hot, and it is Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 18 recommended that hot water outlets are individually regulated. Radiators and hot surfaces are not guarded but have been risk assessed. Portable electric appliance testing has not yet taken place, but plans are in place for this to happen. The Manager confirmed that all windows above ground floor level had restricted openings. Insurance certificates for the house, staff and vehicles were seen. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 19 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 2 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kanner Project (Wixenford) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 2 x D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 20 yes 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 YA1 Regulation 17 Requirement Copies of contracts and terms and conditions between the home and residents must be kept at the home. The front path and handrail must be repaired and made safe. Testing of portable electrical appliance must take place. The registered person must establish and maintain a system for reviewing and improving the quality of care in the home. Timescale for action 31/8/05 2. 3. 4. YA24 YA42 YA39 23 13 24 31/8/05 30/7/05 31/8/05 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. 3. 4. Refer to Standard YA24 YA24 YA 26 YA26 Good Practice Recommendations A plan and timescale for maintenance and refurbishment of the house should be established. Consideration should be given to improving the garden and ensuring it is interesting and accessible to the residents. The bed base in the downstairs bedroom should be replaced. Consideration should be given to supplying an air conditioning system to ensure the first floor bedroom remains at a comfortable temperature for the resident D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 21 Kanner Project (Wixenford) 5. YA42 concerned. It is recommended that individual temperature control devices are fitted to hot water outlets used by residents. Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. Extracts may not be used or reproduced without the express permission of CSCI Kanner Project (Wixenford) D52-D04 S47799 Kanner V222057 290605 Stage 4.doc Version 1.30 Page 23 - 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. 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