Inspection on 07/11/05 for Karamea Care Homes

This inspection was carried out on 7th November 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Karamea Care Homes 28/09/07

Karamea Care Homes 14/09/06

Karamea Care Homes 03/05/05

Karamea Care Homes 13/01/05

Karamea Care Homes 12/07/04

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Fairways

Treloar College

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

CARE HOME ADULTS 18-65 Karamea Care Homes, 1 & 2 Church Mews Church Street Theale Reading Berkshire RG7 5BZ Lead Inspector Katy Brown Unannounced Inspection 7th November 2005 13:45 DS0000011211.V263895.R01.S.doc Version 5.0 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 DS0000011211.V263895.R01.S.doc Version 5.0 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. DS0000011211.V263895.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Karamea Care Homes, 1 & 2 Church Mews Address Church Street Theale Reading Berkshire RG7 5BZ 0118 930 3695 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 Debbie Dickinson Miss Teresa Bieny Care Home 8 Category(ies) of Learning disability over 65 years of age (8) registration, with number of places DS0000011211.V263895.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd May 2005 Brief Description of the Service: Church Mews cares for six adults. It is set back from the main road, but still in a residential area close to local amenities and the town centre. The houses are on two floors and there are some aids and adaptations in the bathrooms to allow residents to move about more independently. All of the bedrooms are single and some of them have en-suite facilities. There is one communal toilet on the ground floor of each house. Public transport is available for the residents’ and the home also has its own transport. DS0000011211.V263895.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over three and a half hours. There have been no additional visits made to the homes since the last unannounced inspection. A tour of the premises took place and residents’ care records and some of the homes’ records were inspected. Three residents’ were spoken to during the visit and one member of staff that was on duty and the manager were also spoken to. What the service does well: What has improved since the last inspection? What they could do better: The statement of purpose and the service user guide must be updated to give a clear understanding of the situation in the home. Not all staff have had training in abuse and protection of vulnerable adults, although they sometimes work with the residents on their own. When employing new staff, the manager does not check that the references are genuine and it is not clear whether the manager has discussed any concerns about an applicants’ personal life or employment history with them. DS0000011211.V263895.R01.S.doc Version 5.0 Page 6 These are things that are required by the Care Homes Regulations 2001. The social services accreditation team visited the home earlier this year and have made specifications regarding staff training and changes to some policies. These are recommendations that have been made. 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. DS0000011211.V263895.R01.S.doc Version 5.0 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 DS0000011211.V263895.R01.S.doc Version 5.0 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 the following standard(s): 1 & 2. Residents are provided with the information that they need prior to moving into the home and have all received social services care needs assessments. EVIDENCE: The statement of purpose and the service user guide include the information specified in the Care Homes Regulations. However, some information is out of date and both documents need to be amended to give an accurate reflection of the situation at the home. The residents have lived at the home for a number of years and received care needs assessments prior to their admission; social services have also completed a re-assessment of need for them. All the residents have recently received a review of care and the manager confirmed that the residents are given an opportunity to attend their reviews if they choose. Changes in need for the residents are acted on by the home. DS0000011211.V263895.R01.S.doc Version 5.0 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 the following standard(s): 6 & 9. All the residents have plans of care in place that give an accurate reflection of their needs, goals and levels of risk. EVIDENCE: Individual plans of care are available for all the residents. The plans of care are detailed and contain information about their healthcare needs, dietary requirements, personal care needs, likes and dislikes and hobbies and interests. Evidence was seen that identified that the residents care needs are reviewed and changes in need are acted on. Discussions with the residents and staff confirmed that the plans of care give an accurate reflection of their needs. All the residents have completed risk assessments in place for the risks that have been identified. Risk assessments are reviewed annually or more frequently if required. DS0000011211.V263895.R01.S.doc Version 5.0 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 the following standard(s): 13, 15 & 17. Residents are provided with opportunities to take part in and explore local community events. Relationships with families and friends are encouraged, supported and maintained and the staff ensure that the meals that are provided are balanced and nutritious. EVIDENCE: There are a variety of activities arranged, many of which are away from the home e.g. keep fit classes, bowling, attending football matches and taking part in community health walks. Two residents said that they were going out for a drive later on that day and one of the resident’s relatives occasionally meets them at the bowling alley and takes part in the games. Staff support residents’ to maintain contact with friends and family and one resident said that her sister had visited that week. Visits by friends and relatives are encouraged at the home and staff and the manager confirmed that they always make visitors feel welcome. The residents have photographs and keepsakes in their rooms to maintain a family orientated environment. DS0000011211.V263895.R01.S.doc Version 5.0 Page 11 The meals that are provided at the home are varied, balanced and nutritious and reflect the individual preferences of the residents. The staff are aware of the residents dietary requirements and provide the individual level of support that is required for each resident. The residents said that their food is nice and that they always have enough to eat and drink. DS0000011211.V263895.R01.S.doc Version 5.0 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 the following standard(s): 19. The residents’ are provided with a good standard of care that meets their health needs. EVIDENCE: A record is kept of all health related visits. Records that were inspected indicate that care staff and the manager have a good relationship with healthcare professionals and referrals are made for specialist support when required. Some residents require support with enemas and rectal diazepam and staff have received the appropriate training, guidance and support from the district nurse and appropriate health specialists to manage these needs. Most residents have now received their annual flu jab. DS0000011211.V263895.R01.S.doc Version 5.0 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 the following standard(s): 22 & 23. All staff must receive training in abuse to protect the residents from harm. The residents are supported to make complaints and all complaints are treated seriously. EVIDENCE: All residents have a copy of the complaints procedure. The residents that were spoken to said that they had not made a complaint as they were happy with the home and the staff. The manager and staff keep a satisfactory record of complaints that are made. The CSCI has not received any complaints in respect of this service. The home has a satisfactory policy for abuse and has adopted the Berkshire Inter-Agency Procedures. The manager confirmed that although some staff have received training in the protection of vulnerable adults, there are staff that still work independently with the residents without this training in place. The home has safeguards in place to minimise the risk of financial abuse to the residents and staff are not able to access the residents’ funds on their own. DS0000011211.V263895.R01.S.doc Version 5.0 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 the following standard(s): 24. The residents live in a safe environment that is able to meet their needs. EVIDENCE: A tour of the premises identified that the home is well decorated and the furniture looks nice. Residents have their own bedroom and some rooms have en-suite facilities. There are separate lounge and dining room areas and a warm and homely atmosphere presents throughout the environment. The garden is spacious and there is a trampoline and a football area for the residents to take part in leisure activities if they choose. The residents said that they were happy with their home and liked living at Church Mews. DS0000011211.V263895.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 & 34. Competent staff support the residents. However, the recruitment practices at the home must be reviewed to ensure that the residents are protected. EVIDENCE: The residents said that the staff at the home are kind and care for them well. Staff were observed demonstrating a good awareness and understanding of the residents needs and regularly interact with them. The home has a staff compliment that is a rich mixture of experience, skills and knowledge. Currently there are four members of staff that have achieved NVQ level 2 or above. Other members of the team have either already commenced the qualification or are scheduled for attendance. There have been four new members of staff that have been recruited at the home since the previous inspection. Although the required checks for staff have been completed and criminal records bureau disclosures and checks against the protection of vulnerable adults lists, had been received. The manager does not check the authenticity of references that have been received and the reference request does not ask whether the applicant had previously been involved in any disciplinary issues, or whether the employer would reemploy them. Also the home does not keep a record of the interview with prospective staff and there is no evidence that any areas of concern regarding DS0000011211.V263895.R01.S.doc Version 5.0 Page 16 staff personal history or employment history has been explored or addressed by the manager. DS0000011211.V263895.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 42. The manager ensures that the home is well run and the welfare of the residents is met through the policies and care practices at the home. EVIDENCE: The residents and staff say that the home is well run and the manager is liked and trusted. The manager of the home has completed NVQ level 4 in Management and Care and the Registered Managers Award. She has 15 years experience working with people with learning disabilities and has been managing the home since August 2005. The manager is now registered with the Commission. The home has satisfactory health and safety policies and procedures in place and most staff have completed training in manual handling. The social services accreditation officer visited the home earlier this year and specified that staff receive training in health and safety and medication administration; the manager confirmed that she is seeking this training for staff. Regular maintenance checks are completed for equipment used at the home and a visit DS0000011211.V263895.R01.S.doc Version 5.0 Page 18 by the fire fighting equipment and fire alarm specialists earlier in the year raised no concerns. Regular fire checks and drills are carried out at the home. DS0000011211.V263895.R01.S.doc Version 5.0 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 3 3 X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 1 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000011211.V263895.R01.S.doc Version 5.0 Page 20 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. 1. Standard YA1 Regulation 6 Requirement Timescale for action 07/12/05 2. YA23 13 (4) (c) 3. YA34 19 & 13 (4) (c) The registered person reviews and updates the statement of purpose and service user guide to give an accurate reflection of the situation at the home. The registered person ensures 07/03/06 that all staff receive training in abuse and protection of vulnerable adults. The registered person ensures 07/12/05 that that they check the authenticity of references that are received for applicants and that any areas of concern about an applicants personal history, or employment history are formally discussed and recorded. 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 YA42 Good Practice Recommendations The registered person ensures that the specifications made by the social services accreditation officer are met. DS0000011211.V263895.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 DS0000011211.V263895.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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