Inspection on 28/04/05 for Mansion House

This inspection was carried out on 28th April 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 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

Mansion House 05/02/08

Mansion House 11/07/06

Mansion House 04/10/05

Mansion House 15/11/04

Mansion House 10/05/04

Similar services:

Dovedale Court

Lyncol House

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

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

CARE HOME ADULTS 18-65 Mansion House 15 Mansion Row Brompton Gillingham Kent ME7 5SE Lead Inspector Robert Pettiford Unannounced 28 April 2005 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mansion House Address 15 Mansion Row Brompton Gillingham Kent ME7 5SE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Care Home 15 Kent Assessment Training Services (Medway) Category(ies) of Learning disability (15) registration, with number of places Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15 November 2004 Brief Description of the Service: Mansion House is a large detached Victorian property, located in a residential area on the outskirts of Chatham and Gillingham town centres. It is a 15 bedded home that provides 24 hour care to adults who have a learning disability and present challenging behaviour. The Service User accommodation is sited on 3 floors, all bedrooms are single and there are ample communal areas. Bathing and toilet facilities are located on all floors. There is a large garden to the rear of the property that is easily accessible to the Service Users. The front garden is laid to lawn and this also provides parking facilities for staff and visitors. Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection at Mansion House took place on 28th April 2005 at 9:00am. The Inspectors agreed and explained the inspection process with the Manager. Documentation and records were read, including care plans. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. A tour of premises was also undertaken. The focus of the inspection was to assess Mansion House in accordance to the National Minimum Standards for Younger Adults. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with which included a number of residents. What the service does well: What has improved since the last inspection? What they could do better: Detailed risk assessments to ensure the safety of service users and others were basic and in need of updating to ensure all risks are assessed. Service users are potentially at risk from abuse due to lack of staff training in Adult Protection and other areas of key training, although it is accepted that the home has had a high turnover of staff recently. Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 6 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. Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected on this occasion. To be inspected at the next Inspection. EVIDENCE: Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,9,10, Whilst the majority of service users had benefited from improved care plans that reflected needs and lifestyles, further development was needed to ensure all care plans had been updated. Detailed risk assessments to ensure the safety of service users and others were basic and in need of updating. Service users records were kept in accordance with the standards with regard to confidentiality and access. EVIDENCE: In the previous inspection care plans showed good detail and depth of information, however the format made it unclear to see whether goals are being achieved. The home is still in the process of updating its care planning system. On care plans viewed many had been updated to show what support was needed, how and by whom. The documentation showed reviews are taking place regularly and key-working (one to one with residents) sessions are in place. The Manager stated that further work was needed to make the care plans clearer. Detailed risk assessments to ensure the safety of service users and others were basic and in need of updating to ensure all risks are assessed on the care plans viewed. Risk assessments were not undertaken in relation to each Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 10 service user that promote and enable independence i.e. access to the community for one example seen. The Home has a confidentiality statement as part of the Home’s policies and procedures. Service users can have access to records relating to their care if they wish. Records are available to authorised and appropriate staff only and are stored securely when not in use. Staff were seen to be discreet in their discussion of service users and their needs, and no public display of confidential information was observed during the inspection. Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,17, Service users have opportunities to maintain and develop social, emotional, communication and independent living skills. Service users are supported to continue their education or training, and / or take part in valued and fulfilling activities. Service users take an active part in community based activities and feel part of the local community. Service users are offered a well balanced menu and choice of food EVIDENCE: Following the review of an example of some of the care plans and discussions with staff and service users, it was evident that service users are enabled to participate and contribute to meeting their own self-care needs and help in day to day chores around the house. Service users have opportunities to learn and practice life skills as part of their planned individual activity programme’s. Such opportunities are undertaken with the support, encouragement at a level appropriate to their needs and wishes. Evidence was available that showed commitment to support service users in appropriate activities. Examples of such included regular attendance by service user at college and other activities. Service users are supported by staff to participate in a wide range of activities in accordance to their needs and Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 12 wishes. Service users have been enabled to and encouraged to participate in hobbies and activities which they had an interest in. Meal times are flexible to suit the service users’ activities and schedules. Service users are able to choose where to eat, and also have facility to make drinks, meals and snacks for themselves and others. Service users confirmed that they had been involved in planning and choosing menus. During the inspection food storage areas were inspected along with quantity and quality of food. A good variety of food was found including meat, vegetables and fresh fruit. Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20 Service users healthcare needs are well supported. The welfare of service users is protected by the home’s policy and procedures with regard to the administration of medication. EVIDENCE: The Inspector viewed the care records relating to several service users. Records viewed confirmed service users had accessed a range of health care inputs including access to their chosen G.P (where possible), Dentist, Optician in addition to identified individual specialist health care. The manager said service users were accompanied to hospital and other appointments. The manager reported at the time of the inspection no service users were undertaking management of their own medication. The inspector viewed the medication storage arrangements and some records including Medication Administration Record (MAR) sheets, and the protocols for the administration of “PRN/As Required” Medication. The Home uses a Monitored Dosage System and it was evident the Home had sought advice and information from the supplying pharmacist. Only authorised staff members undertake the administration of medication following training. Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Service users know that their concerns and complaints are taken seriously. However service users are potentially at risk from abuse due to a high turnover of staff and a consequent lack of staff training in Adult Protection. EVIDENCE: The inspector viewed a copy of the Home’s complaints procedures. The procedure included details of how to complain, timescales for response and information for referring a complaint to the Commission for Social Care Inspection A copy of the complaints procedure has been provided and explained to service users. The home has policies and procedures with regard to abuse, but following a review of staff training only 6 out of 21 staff have received any Adult Protection training. However it is accepted that 10 staff have joined the home in the last six months Training was last provided in July 2004. The Manager stated that this will be addressed as a priority and further training would be provided. Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected on this occasion. To be inspected at the next Inspection. EVIDENCE: Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35,36 Service Users needs are supported by the staff. However, because of a high staff turnover, many staff still lack training in important key areas. Service users do benefit from well supported and supervised staff. EVIDENCE: From discussions with the Management, observations and reviewing the staff rotas sufficient staff were on duty at the time of inspection to meet the service users basic needs. The rota indicates that the home provides four staff for the AM shift with four working on the PM/evening. two waking night staff are also provided. Following a review of the staff training matrix it was evident that further training was needed to ensure that all staff were appropriately trained. Basic core training with regard to Health and Safety, Fire, Adult Protection, Physical restraint/ breakaway techniques, Adult Protection were seen as a priority for all staff. The Manager stated that this will be addressed and further training would be provided. On evidence provide by the manager it showed that staff are supervised on a regular basis in accordance with the standards. Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected on this occasion. To be inspected at the next Inspection. EVIDENCE: Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 x x 2 Standard No 31 32 33 34 35 36 Score x x 3 x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mansion House Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 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. 1. Standard 6 Regulation 15(1) Requirement 15.—(1) Unless it is impracticable to carry out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (“the service user’s plan”) as to how the service user’s needs in respect of his health and welfare are to be met. 12.—(1) The registered person shall ensure that the care home is conducted so as— (a) to promote and make proper provision for the health and welfare of service users; (b) to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. 13.—(6) The registered person shall make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. 18.— (1) The registered person shall, having regard to Timescale for action 28/07/05 2. 9 12(1) 28/07/05 3. 23 13(6) 28/07/05 4. 35 18(1) 28/10/05 Page 20 Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 the size of the care home, the statement of purpose and the number and needs of service users— (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users; 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 Good Practice Recommendations Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Mansion House H56-H06 S28936 Mansion House V223478 280405 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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