Inspection on 10/04/07 for Little Ewell

This inspection was carried out on 10th April 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

Little Ewell 24/01/06

Little Ewell 10/08/05

Little Ewell 10/02/05

Little Ewell 13/10/04

Little Ewell 11/12/02

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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 Little Ewell Barfrestone Dover Kent CT15 7JJ Lead Inspector Christine Lawrence Key Unannounced Inspection 10 April 2007 09:50 Little Ewell DS0000023479.V333805.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 Little Ewell DS0000023479.V333805.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. Little Ewell DS0000023479.V333805.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Ewell Address Barfrestone Dover Kent CT15 7JJ 01304 830930 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) vanaerts@btinternet.com L’Arche (Registered Office) Hiromi Umizawa Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Little Ewell DS0000023479.V333805.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24 January 2006 Brief Description of the Service: Little Ewell is one of the houses within the LArche (Kent) Community. It is a large detached property set in its own grounds. The main house has accommodation on two floors, with five single rooms for residents. There are a further two rooms in an adjacent property, known as the ‘flats’. Some of the staff are permanent but others come from many different countries to be part of the community within the home and within the area for a specific period of time. The home is located in a small village with limited access to public transport or amenities. There is a church and public house nearby, although the nearest bus service and railway station, shops and post office are approximately 1½ miles away. The home has a minibus and car for residents’ transport needs. There is off road car parking and extensive well maintained gardens which are accessible to residents. Information about the home, including the latest report from the Commission for Social Care Inspection (CSCI). Information included in the pre-inspection questionnaire provided by the manager on 29 March, confirmed the fees as between £641.00 and £1351.00 per week. Little Ewell DS0000023479.V333805.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 09.50 and finished at 13.15. The inspector looked at various records in the home and also used information sent to the Commission by the manager before the visit (the pre inspection questionnaire). Information from the previous inspection was also referred to. The inspector spoke with several residents and also to various members of staff. A tour of parts of the building was undertaken. The inspector made observations of staff interacting with residents. The day of the inspection was just after Easter and residents were on holiday from their usual workshops. They were getting ready to go out. The routine of the day was relaxed. The manager was not present and this inspection was carried out with the assistant manager. 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. Little Ewell DS0000023479.V333805.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 Little Ewell DS0000023479.V333805.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ individual aspirations and needs will be assessed. EVIDENCE: Three individual records were looked at for this inspection. It is clear that new residents will only be admitted after a detailed assessment process which includes getting information from the placing authority’s representative. The assessment information is used to compile a care plan. The format being used in the home is based on person centred planning and focuses on an individual’s wishes as well as their needs. Little Ewell DS0000023479.V333805.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): Quality in this outcome area is good. 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: The individual records of three of the residents were viewed. The information was up to date and clearly written, covering a range of subjects including risk assessments, behaviour, communication, hopes for the future, independence and skills. Talking to staff and observing residents gave the inspector examples of residents making decisions about their routines and daily lives. The commission was informed through the pre inspection questionnaire that the organisation provides appointees for all residents although they all also have individual building society accounts. Little Ewell DS0000023479.V333805.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is good. 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 being offered a healthy diet and a sociable setting for mealtimes EVIDENCE: Residents are provided with opportunities to attend workshops operated by L’Arche (Kent), as well as college courses and day services provided by other organisations. Residents are all on the electoral roll and they have opportunities to use community facilities both locally (such as the pub) and through their workshops during the day and social events at various times. The manager and staff enable residents to maintain contact with family and friends and there are often celebrations within the house that involve inviting friends and family. As noted in the previous standard residents are encouraged and enabled to make decisions and be as independent as possible. Their rights are respected and there is also an expectation that they will be Little Ewell DS0000023479.V333805.R01.S.doc Version 5.2 Page 10 involved in personal and communal housekeeping tasks. Residents have time when they can carry out their laundry and cleaning of their rooms with appropriate staff support or help. The inspector saw that residents could choose to be with everybody or spend time on their own. It was noted that the menu is varied and nutritious, offering choices. The evening meal is a sociable occasion and the furniture in the dining room allows for everyone to be together on one table. Information about any preferences or special needs is contained within the care plan under ‘diet’. Little Ewell DS0000023479.V333805.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. 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. EVIDENCE: Residents seen during this inspection were individual in their appearance and the inspector was informed that individuals make choices about their clothes and hairstyles. Residents’ needs with regard to the level of support they require for personal care varies according to their abilities for instance one person might need lots of help and another might only need encouragement. Information about personal hygiene preferences as well as information about morning routines is provided within the individual plan. Wherever possible, and that is most of the time, a male assists a male and a female assists a female. There are male and female staff within the home. The records seen indicate that residents health care needs are identified and responded to with attention from dentists, opticians, general practitioner, community nurses, dietician, continence advisor etc. Medication is appropriately stored and administration is properly recorded. Although the senior member of staff who is responsible for managing medication has achieved her national vocational Little Ewell DS0000023479.V333805.R01.S.doc Version 5.2 Page 12 qualification level 3, she has yet to attend a training course specifically about medication. Some staff have received training regarding medication. There are in-house procedures for medication but the member of staff spoken to was not aware of the Royal Pharmaceutical Society of Great Britain’s guidelines. The inspector was informed that the home is in the process of introducing individual health action plans. Little Ewell DS0000023479.V333805.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): Quality in this outcome area is good. 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 individual planning, key worker system and regular house meetings are used to ensure that residents’ views and concerns are noted. There are policies and procedures in place regarding complaints. A poster, using pictures, is on display for residents to assist them in knowing who to talk to if they have a problem. There are policies and procedures relating to adult protection and whistle blowing and these were reviewed in December 2005 and November 2006 respectively. The home also has the new multi agency procedures from Kent County Council’s social services department. A policy regarding aggression toward staff is in place. There is a policy about the use of restraint. A policy regarding bullying is also in place. Little Ewell DS0000023479.V333805.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): Quality in this outcome area is good. 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 communal areas – two lounges, a dining room and a chapel – are bright and cheerful areas. There are lots of plants around and attractive paintings and prints on the walls. The home has a comfortable, lived-in feel about it. Some areas of the house need decorating. A handyman is employed part time to carry out basic repairs etc. The laundry is a spacious area and is satisfactorily fitted out. There are polices regarding infection control and the home was clean and fresh on the day of the visit. Little Ewell DS0000023479.V333805.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): Quality in this outcome area is good. 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: There is a detailed training programme in place. This specifies the topics or stages, followed by the criteria for participants, goals to be achieved, course content and structure. This allows for supporting staff members who are working for short periods of time as well as those who continue to work within the L’Arche community. The ‘assistants co-ordinator’ is responsible for planning the training and ensuring that staff are enabled to attend. Induction training is provided. The programme includes national vocational qualifications. It was not possible to view staff records during this visit but information provided by the manager prior to the inspection and a telephone interview with the ‘assistants co-ordinator’ confirmed the organisation’s recruitment procedures which include application forms, references, terms and conditions of employment and criminal record bureau checks. The policies and procedures which the organisation has in place cover relevant aspects of recruitment. Little Ewell DS0000023479.V333805.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): Quality in this outcome area is good. 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: Hiromi Umizawa is experienced and has a Diploma in Welfare Studies. She is currently undertaking further training through the Tizard Centre at Kent University. When this is completed she will be looking at any further training necessary to count towards the registered managers award. Although the home can demonstrate that it takes account of the views of residents, the organisation as a whole is still looking at the best way of monitoring quality. Little Ewell DS0000023479.V333805.R01.S.doc Version 5.2 Page 17 Training is provided to all staff regarding moving and handling, fire safety, first aid and food hygiene. This training forms part of the induction process for all new staff across the organisation. Although there is no formal training for infection control there are written procedures which also form part of induction. They include health and safety guidelines, dealing with body fluids and a hand-washing guide. Information provided by the manager prior to the inspection relating to maintenance and servicing indicates that everything is appropriate and up to date. One member of staff has particular responsibility for monitoring health and safety. Little Ewell DS0000023479.V333805.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 2 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 2 X 3 X 2 X X 3 X Little Ewell DS0000023479.V333805.R01.S.doc Version 5.2 Page 19 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 YA20 YA24 YA39 Good Practice Recommendations Further training regarding medication to be provided to the assistant manager Necessary redecoration should go ahead The organisation should clarify how quality will be monitored within the home Little Ewell DS0000023479.V333805.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Little Ewell DS0000023479.V333805.R01.S.doc Version 5.2 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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