Inspection on 28/09/07 for Kingsdown House

This inspection was carried out on 28th September 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

Kingsdown House 11/05/06

Similar services:

Insight - Eastchurch

Southfields

Thorndene

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Seabourne House

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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 Kingsdown House 46 Goddington Road Strood Kent ME2 3DA Lead Inspector Joseph Harris Key Unannounced Inspection 28th September 2007 10:00 Kingsdown House DS0000066244.V350371.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 Kingsdown House DS0000066244.V350371.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. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsdown House Address 46 Goddington Road Strood Kent ME2 3DA 01634 717084 01634 717061 kingsdown.house@achuk.com www.achuk.com Aitch Care Homes (London) Limited 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) Vacant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2006 Brief Description of the Service: Kingsdown House is a home for nine services users between the ages of eighteen and sixty-five, who have been diagnosed as having a learning disability. Their needs can be complex and can present a challenge to the service. Some of the Residents may have autism and / or epilepsy and have specific needs associated to this. The aim of Kingsdown House is to provide accommodation in a home like environment. The home is located in a residential area within walking distance of shops and local amenities and has its own vehicle for the service users benefit. The property is a large spacious detached house and has a lounge/diner, kitchen, and a bathroom and toilet on the lower floor. There is also a visitors/1:1 room and a relaxation summerhouse in the garden. All nine bedrooms are single occupancy with en-suite bathrooms or wet rooms. Three of the bedrooms are on the ground floor and six of the bedrooms are on the upper floor. The secure garden to the rear of the property includes a patio area. The fees charged by the home are £1355.00 per week, plus an additional £8.00 per hour for one to one support for service users as required. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection process culminated in a site visit to the home on 28th September 2007. The site visit commenced at approximately 10am and concluded at 4.00pm, lasting for around 6 hours. During the course of the visit a tour of the premises was undertaken and discussions were held with the manager, staff members and service users. A range of documentation was examined relating to the residents, staff, medication, health and safety and the day-to-day running of the home. The home also returned the Annual Quality Assurance Assessment (AQAA), which provides information to inform the inspection process. What the service does well: What has improved since the last inspection? The organisation has improved training in respect of medication issues for staff and NVQ. Policies and procedures relating to ageing service users have also been introduced. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 6 The manager stated that the home has tried to develop a greater range of activities and is looking to continue to work on this area. 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. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. The needs and aspirations of prospective service users are assessed appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All referrals to the home are received through a central referrals team for the organisation. On receipt of the referral initial enquiries are made to ensure the suitability of the prospective service user for a potential placement in one of the organisation’s homes. Written information is received including a referral form and copies of any care management documentation where possible. Once allocated to the home as a potential placement a visit is made to the see the service user where more detailed information is compiled covering all areas of care and support. An example of a completed referral form was examined that contained clear and holistic information. Following this process a series of visits to the home are arranged at a pace that is comfortable for the individual. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. All service users have an individual service user plan developed and are able to make decisions affecting their day-to-day lives in accordance with assessed risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 3 individual service user plans were examined, all of which demonstrated that all aspects of care and support are suitably planned for and monitored. Care planning is covered through two sections of the service user files. One part is written in a narrative style providing guidance on issues surrounding personal care needs, support, communication needs and preferences amongst other things. The second part covers behaviour management issues and management guidance including individualised procedures for physical interventions and breakaway techniques. The information contained within Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 10 each plan of care was linked to assessment information, providing detailed guidance to enable staff to meet individual needs. The home should ensure that there is clear evidence that all aspects of the individual plans are reviewed and updated as needs change. Refer to recommendation 1. Service users are enabled to make decisions affecting their lives within a clear risk management framework. The home does not act as an appointee for any service users and their finances are managed by appointees independent of the service. The home has developed clear and balanced risk assessments covering all aspects of perceived risk for each service user based on knowledge of the individual and via assessment information. However, one oversight was noted in the risk management of a health issue for one service user. This was discussed with the Manager who acknowledged this and agreed to assess this area and develop management guidance for staff. There was evidence that all risk assessments are regularly reviewed and updated as required. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. Service users have the benefit of a varied and active lifestyle that suits individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users in the home have a range of opportunities open to them of a social and recreational nature. The staff were observed to spend time with the residents engaging in a variety of informal activities throughout the day. Staff are available to support residents in the community participating in planned activities such as horse riding, trampolining and swimming. Staff go out for walks and to the shops with service users on a one to one basis or in small groups. Residents can access day and evening clubs to meet with friends and socialise along with engaging in some therapeutic activities. The home has Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 12 developed individual and general activity planners. Some residents also attend college courses on a weekly basis. It was reported that visitors are welcomed into the home at all reasonable times and that staff liaise with family members as appropriate. It was not possible to speak to any visiting relatives during the site visit. Menu records are maintained and there was a good range of food available in the kitchen. The kitchen area is domestic in style, but provided very good facilities for food preparation. Care staff undertake all cooking duties supported by service users where appropriate. There is a comfortable dining area and meals are taken in a relaxed atmosphere. The home ensures all dietary requirements whether health related or for cultural and religious purposes are catered for. Two service users spoken to said that they enjoyed the food that they get. Staff reported that residents are involved in the process of planning and shopping for meals. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. Service users health and personal care needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A number of staff members were spoken to throughout the course of the site visit, all of whom demonstrated a good understanding of the individual needs of the service users. All personal care and support is provided in private and is delivered in a manner that suits the needs of each individual. A personal profile has been developed for each resident that clearly sets out the nature and level of support to be provided to each person taking into account abilities and choice. The home monitors healthcare issues well ensuring that all appointments and consultations are attended. Some service users require fairly high levels of support when attending to some healthcare needs and staff provide this support in a sensitive and thoughtful manner. Residents have access to a range of healthcare professionals. All are registered with local GPs and have Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 14 access to community learning disability services. Complimentary healthcare is also provided through dentists, chiropodists and dieticians, etc. Medication records and storage was examined and is well managed. The home has developed policies and procedures covering all aspects of medication process. Storage facilities are secure and well kept. Medication administration records were up to date and well maintained. None of the current service users are assessed as being able to self-medicate. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Service users are listened to and their views acted upon. Residents are protected from forms of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has clear structures and policies in place relating to the complaints process. This policy is made available to all visitors and representatives of service users and meet all requirements. Staff were observed to listen and act upon issues raised by service users and demonstrated good communication skills. A number of complaints and concerns have been received directly to the Commission for Social Care Inspection since the last inspection regarding levels of supervision for service users in the home and incidents of violence have been reported. There have been two adult protection alerts raised since the last inspection concerning physical aggression between service users both of which have now been resolved and closed. Policies and procedures are in place relating to issues of abuse and there is a good working knowledge amongst staff of the importance of observing signs and the reporting and recording of any alleged abuse. All staff cover adult protection issues through the induction process and do an additional course Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 16 covering this topic. Polices and procedures are in place regarding incidences of aggression and individualised procedures are developed where the potential for physical interventions may be required. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome area is good. The home provides a comfortable and conducive environment for the needs of all service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Kingsdown House, arranged over two floors, has been extensively renovated and upgraded by the organisation to provide a comfortable, homely, bright and airy environment. The home is within reasonable walking distance of the town centre, which has public transport links. All bedrooms are single rooms with en-suite facilities. There are also toilets and bathrooms located throughout the house appropriately. There is a main lounge attached to an open plan dining area that provides suitable space for relaxing, taking meals and activities. There is also additional space for residents to sit in quieter surroundings. To Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 18 the rear of the house there is a good-sized and well maintained garden, which has a summerhouse containing a sensory room. Laundry facilities are domestic in style and suitable for the needs of the home. The home reportedly meets the requirements of the environmental health and fire departments. All hazardous substances are stored securely and the home is clean, hygienic and free from odour. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 19 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. Quality in this outcome area is good. The staff team are suitable recruited, trained and supported to ensure the needs of the service users can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The organisation actively supports staff to work towards their National vocational Qualifications (NVQ) and around 50 of the staff team have achieved an NVQ level 2 or above. There has been a relatively high turnover of staff in the past 6 months, but it was reported by the manager that there is now a settled staff team. Staff spoken to demonstrated a good level of knowledge about the residents they work with. The home manages the recruitment of staff well and a number of staff personnel files were viewed which contained all relevant documentation including two written references, application form and relevant security checks. The home employs a number of staff from overseas and recruitment checks are carried out appropriately for these individuals. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 20 Staff are provided with the necessary training to undertake their roles. There is an in-house induction programme and some staff have taken a general induction programme organised through an outside agency. It is recommended, however, that the home introduces an induction programme in line with the skills for care common induction standards. Refer to recommendation 2. The home did not have an up to date training matrix, refer to recommendation 3, but certificates are held on file demonstrating that staff complete all required mandatory training and additional courses covering service specific issues such as medication, adult protection, management of aggression and awareness of learning disabilities and related health issues. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 21 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. Quality in this outcome area is good The home is well run and in the best interests of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The present manager has been in post for approximately 6 months and has applied for registration. She has a number of years of experience in the field of learning disabilities in care home settings and has created a positive and open atmosphere in the home. Staff stated that they are able to offer ideas and feel included in the running of the service. The manager has continued to undertake training and has achieved her NVQ level 4/RMA. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 22 The organisation has well developed quality assurance systems including regular monthly visits and reports for a senior manager, service user, relative and professional surveys, which are collated into an annual report. The home holds regular staff meetings and aims to include service users in the running of the home wherever possible. All health and safety documentation and certificates was well organised and up to date. A health and safety audit is completed by staff periodically and all service certificates including CORGI gas safety, NICEIC and PAT tests. Fire safety logs are kept up to date and there are safe systems of work in place. Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 23 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 Kingsdown House DS0000066244.V350371.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA6 YA35 YA35 Good Practice Recommendations To ensure that a robust and clear system for the review of care plan documentation is in place. To develop an induction programme in line with the Skills for care Common Induction Standards To develop an up to date training matrix. 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