Inspection on 22/02/08 for King Edward House

This inspection was carried out on 22nd February 2008.

CSCI found this care home to be providing an Good service.

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

King Edward House 03/03/07

King Edward House 10/01/06

King Edward House 21/06/05

King Edward House 03/12/04

King Edward House 15/06/04

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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 King Edward House 77 New Street Ash Canterbury Kent CT3 2BW Lead Inspector Christine Lawrence Key Unannounced Inspection 22 February 2008 13:40 King Edward House DS0000023215.V357734.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 King Edward House DS0000023215.V357734.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. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service King Edward House Address 77 New Street Ash Canterbury Kent CT3 2BW 01304 812953 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) Mr Rex Slade Cadman Mr Rod-Rennie Cadman Care Home 6 Category(ies) of Learning disability (6) registration, with number of places King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3 March 2007 Brief Description of the Service: King Edward House is in the village of Ash approximately 10 miles from Canterbury. The home is registered to provide personal care and support to 6 people with learning disabilities. The accommodation consists of four single bedrooms and one double bedroom. There are two bathrooms one on the east side and one to the west side of the house. On the ground floor there is a large living room, kitchen with dining area and additional small lounge, utility room and conservatory area. There are grounds that are laid mainly to lawn, with a parking area to the front and side of the property. The current weekly fees for this service range from £340.00 per week according to individuals’ needs. Information about the service, including a copy of the latest inspection report will be provided on request to the home. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 13.40 and finished at 17.30. We (the Commission for Social Care Inspection, CSCI) looked at various records in the home and also used information sent to us by the deputy manager before the visit. This was the Annual Quality Assurance Assessment (AQAA). Information from the previous inspection was also referred to. We spoke with the residents who live at the home. A tour of the building was undertaken and some of the residents showed their rooms. We made observations of staff interacting with and supporting residents. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents’ individual aspirations and needs will be assessed. EVIDENCE: The individual record of a resident was looked at for this standard. He moved into the home most recently. The home carried out an assessment of his needs prior to moving in. The assessment and care planning process is more ‘person-centred’, as required from the previous inspection and includes information about how the person communicates. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their changing needs will be noted in their individual plans and that they will be supported to make decisions and take risks to enable as independent lifestyle as possible. EVIDENCE: Three individual records were looked at for this inspection. As noted above, the plans are much more ‘person-centred’. The plans have been compiled with the residents. They are reviewed regularly through a document called My Review which helps to underpin the ‘person-centred’ approach. Diagrams are used to illustrate the information. Daily records are completed by staff and staff said that changes would be made to care plans if needs changed before the next review was due. The records showed (and this was confirmed in conversations with residents and staff) that people make decisions about their routines and their own lives. One person said he could get up and go to bed when he wished and another King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 9 said he liked to watch television in his room. Staff have received some training regarding recent legislation which focuses on individuals abilities to make decisions for themselves but they plan to have more guidance about this. Examples were noted of residents’ abilities to mange their own finances being looked at on an individual basis to ensure as much independence as possible. Risk assessments are included in the individual records but these are always based on ensuring an individual has opportunities still to do things. Two examples noted were some difficulties when travelling in a car but not stopping someone from doing so, and a road safety awareness programme. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Activities and involvement in the local community, as well as support for personal relationships will be provided for residents. They will benefit from having a healthy diet. EVIDENCE: Residents us that they have plenty to keep them busy and they, and staff, told us about the various activities they take part in. Pieces of artwork and certificates they have achieved are on display in their rooms. Residents enjoy going into the village to the local shops and to visit friends nearby in another home owned by the same provider. On the day of the inspection visit most of the residents attended a music-based activity nearby and one went for a walk to the village. On their return they watched music television, spent time in their rooms and relaxed in the dining area chatting to staff. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 11 Residents have the support they need to keep in contact with friends and family and they are supported to use facilities in the community. Residents said they share the household tasks and take responsibility for cleaning their own room. Staff said that this is done with staff support and encouragement when needed. Residents do make choices about their daily lives but they also like their own set routines. The residents who spoke up during this visit said they enjoyed the food. One person said “…lunch was good and we had corned beef last night…” and another named a particular member of staff as a “…good cook…”. A third person confirmed that the food was good. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s policies and procedures regarding medication and their physical and emotional needs will be responded to. Their preferences and requirements for support are respected. EVIDENCE: Residents’ personal care needs are included within their individual records and as noted previously, independence is encouraged as much as possible. One resident said “…they help me when I need it…”. The records seen showed that health care professionals are involved with residents as required. The deputy manager said they are planning to introduce health action plans as part of the ‘person-centred’ planning. The medication storage and records of administration were seen and they are appropriate. The policies and procedures regarding medication have been reviewed and updated and staff who give out medication have received training. No one currently wishes to manage their own medication but staff said this would be part of a regular review of wishes. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and their views are listened to and acted on. EVIDENCE: The home has a complaints procedure. Regular residents’ meetings mean that people can talk about any concerns. Residents said they would talk to staff if they were not happy about something. Those who spoke up at this visit said they felt safe at the home and knew that staff would look out for them. The home has an adult protection policy and whistle blowing policy and staff said they have attended training in safeguarding adults. There are guidelines regarding residents’ finances. Improving the complaints procedure by introducing one in a picture format was identified in the AQAA as a plan for the future. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable and safe for the residents. EVIDENCE: The AQAA states that they will continue with plans for areas of redecoration around the home. There are two areas damaged after a leak in the roof and these will be done as a priority. The house is spacious and clean. Décor and furnishings are domestic in style and the people living there clearly feel at home. Residents’ individual and collective needs are met in a comfortable and homely way. The garden was not as attractive as it might be but the deputy manager and senior carer explained some of the reasons for this. They confirmed that work would be done on the garden area in time for the warmer weather. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Sound recruitment procedures and training provided to staff will have a beneficial impact on residents. EVIDENCE: Staffing is flexible with two staff on duty when needed. Extra staff can be called on for outings, activities etc. Staff have the training they need for the job they do. Staff were observed interacting positively and respectfully with residents and showed an understanding of individuals’ needs. It was observed that the staff are accessible to the residents and they demonstrated good listening and communication skills. They involved residents in conversation and encouraged them to speak up. Residents said these comments about staff at the home:- “…helps me do things and doesn’t moan at me…” “…I like the staff…” “…they’re alright, they’re good, …is a good cook…” A staff record viewed for this inspection confirmed that recruitment procedures included application forms, references, interview and criminal record bureau checks. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 16 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home and their health and safety is promoted and protected. EVIDENCE: There is a senior member of staff at the home supported by a deputy manager and manager based at a larger nearby home. Both have NVQs level 4. The registered manager is not based full time at the home but is available for support and advice when needed. The registered manager has not yet completed the qualification required by the national minimum standards. The home uses questionnaires to gather information about residents’ satisfaction with the service provided and this is underpinned by regular monthly residents’ meetings and the key worker system. The improvements King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 17 to the care plans will also help with planning any improvements or changes needed within the home. The AQAA submitted for this inspection could have been completed with more information. The AQAA is an opportunity for services to let us know how well they think they are performing, and can also inform their own quality assurance processes. The policies and procedures have all been reviewed and updated. There is appropriate guidance for staff regarding health and safety. A spot check on service and maintenance contracts showed that they were appropriate and up to date, with a periodic inspection of the electrical installation planned for next week. Staff training with regard to food hygiene, fire safety, infection control, manual handling and first aid has been provided. King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 18 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 X 2 3 3 X 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 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 3 3 3 X 3 X 3 X X 3 X King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 19 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. Refer to Standard Good Practice Recommendations King Edward House DS0000023215.V357734.R01.S.doc Version 5.2 Page 20 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. 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