Inspection on 24/04/07 for Maple House

This inspection was carried out on 24th 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

Maple House 13/06/06

Maple House 05/12/05

Maple House 16/06/05

Maple House 09/12/04

Maple House 13/07/04

Maple House 10/12/02

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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 Maple House 32 Julian Road Folkestone Kent CT19 5HW Lead Inspector Wendy Gabriel Key Unannounced Inspection 24th April 2007 09:45 Maple House DS0000023463.V335891.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 Maple House DS0000023463.V335891.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. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maple House Address 32 Julian Road Folkestone Kent CT19 5HW 01303 251618 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) Lothlorien Community Ltd Mr Robert John Muxworthy Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th June 2006 Brief Description of the Service: Maple House is registered to provide 24hour residential care for up to 6 adults with learning difficulties. Maple House is located in a quiet residential area on the outskirts of the costal town Folkestone. There are public amenities and good transport links close by. The property is a substantial detached house with a parking facility to the front for up to 3 cars. The accommodation is arranged over two floors. There is a large garden to the rear of the property. Fees are £1081.00. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The acting manager at the previous inspection resigned last year and the previous Registered Manager to the home, Mr Robert Muxworthy, has taken on the role again. Seventeen requirements were made at the previous inspection and these have all been met. The Registered Manager was in the home at the time and was able to clearly demonstrate his understanding of the standards inspected. People in the home left for their various morning activities including one to one support. One person spoke briefly to the Inspector on her arrival and others in passing when they returned to the home for their lunch. An accompanied tour of the premises was undertaken; some records were looked at including: medication records, duty rota, a care plan and a staff employment file. What the service does well: What has improved since the last inspection? The home has met all the seventeen requirements from the last inspection. Some re-decoration has been undertaken and a bed has been provided for the spare bedroom/occasional sleep in room. Peoples’ choice of holidays has been taken into consideration and will be planned accordingly. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 6 Staff induction is now up to date and in line with company procedure. Record keeping has improved and is clearer to understand and includes suitable and robust guidance to meet individual risk assessments. 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. Maple House DS0000023463.V335891.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 Maple House DS0000023463.V335891.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home provides for suitable planning and assessment for people considering living there. EVIDENCE: The Registered Manager was able to very clearly explain the pre assessment routine undertaken and pre assessment documents were seen. A statement of purpose and service users guide is available for prospective residents. The Registered Manager discussed the possible admission of a new person to the home that was currently being undertaken. He was clearly aware of included ensuring enough staff will be employed and that the right gender staff will be available at key times. A planned discharge was being organised and the Registered Manager was able to explain the valid reasons for this to meet the needs of the individual. Contracts were discussed and the company are currently reviewing them. The home provides a detailed breakdown of the base fee. Maple House DS0000023463.V335891.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are well managed and identify needs of people who live in the home. Care plans support staff to enable people to make decisions about their own life style. EVIDENCE: The Registered Manager has organised all the care plans since the previous inspection and stated that a new person centred plan has been provided by the owning company and is well underway to being used for all the people living in the home. The care plan viewed, contained improved risk assessments that gave detailed guidance to staff on different aspects of an individuals care. This included a breakdown of different behaviour patterns. This is good practice. Informative advice for staff about the needs of individuals is contained in the plans and includes health care details and information from Health care professionals. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 10 Reviews are undertaken and there are monthly reviews and evaluations of identified risks. Confidentiality is maintained and information is kept in locked facilities in a locked office. Maple House DS0000023463.V335891.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have good opportunities to participate in activities they enjoy. Risk assessments enable activities to be managed. Meals have improved and are still being considered for their nutritional value and variety. EVIDENCE: The Registered Manager stated that the company is no longer talking about providing a day care centre; but instead, the local homes within the company have arranged a number of different clubs that have been proving very successful and that are used enthusiastically by people from the home. Some more clubs are planned including individual men and women groups where people can discuss gender specific health matters. Activities include an area social club where one person from the home also helps out, a fitness club, and a snooker club. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 12 Recently the home has taken part in a bowls tournament organised by the sports venue, where one person from the home won a prize. A ‘Craegmoor Day’ has also been arranged at a sports stadium in Ashford. The Registered Manager said one person attends a resource centre one day a week and since starting there has seen his independence and communication skills increase. This is encouraging and because of this he has been invited by the centre to attend an extra day a week. Other people attend South Kent College. Line dancing is popular and one person told the inspector that he was just leaving to go swimming and was looking forward to that and to a favourite television programme later that day. The rapport between him and the member of staff for this 1-1 activity was knowledgeable and companionable. Another person said he had enjoyed his morning out and was eager to get on with other activities in the home. The Registered Manager said that he and the staff were planning to take three of the people in the home on holiday abroad this year. This is good practice as it meets the choices voiced by those people. Another person has requested a different holiday in Britain and that is to be organised also. Meals have improved since the last inspection and there is more thought given to diet than the previous inspection where there had been a mainly burger, pizza, chips and similar diet. The menus are chosen by people once a week and included a wider choice. The Registered Manager said this is still being worked on and agreed that the home is not stopping choice by offering a wider variety of meals but is in fact increasing choice. Two people who live in the home have attended a 10 week ‘healthy eating’ course. The Registered Manager said they would come home from the course and cook what they had been taught about that day. Maple House DS0000023463.V335891.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good management has improved medication administration. The health and welfare of people is supported by informative record keeping. EVIDENCE: Staff check medication when they hand over at each shift change and this is recorded. Medication administration was accurate and secure. Staff are not allowed to administer medication until they have attended a training course and completed a competency assessment within the home. This is good practice. There is information for staff informing them why and how medication to be given ‘as required’ is used. Medication administration records include a photograph of individuals. Health care is documented and the Registered Manager stated that the g.p. reviews individuals annually. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 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. 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 management of complaints mean that people living in the home and others involved with the home, understand how to make a complaint and what will happen if a complaint is made. Staff training protects people from abuse. EVIDENCE: A complaint procedure notice is displayed in the lobby of the home. There is also a written complaint procedure for any person to view and complete if necessary. Also in the lobby is a complaint format for people living in the home. This is in a plain and easy to understand format. The Registered Manager takes concerns and complaints very seriously and was able to explain the system and procedure for dealing with any received. Training of staff in the area of protection is regularly arranged by the Home. Other training around dealing with physical and verbal aggression is also made available to staff as needed. Commission for Social Care Inspection had not received any complaints about the home since the previous inspection. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 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. 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 and tidy and individual. The Registered Manager has good ideas for refurbishment that if undertaken will improve the environment. EVIDENCE: The Registered Manager discussed decoration and refurbishment of the home and said he planned to make some changes but has been unable to fully undertake this because of a limited budget from the company. The kitchen was clean, tidy and well stocked but looked impersonal and dated. There are padlocks on many of the cupboards and the Registered Manager said he wanted to replace the cupboards and have new locks that are discrete, magnetic but secure. A recommendation is made for this to be undertaken to provide a more homely environment in the kitchen. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 16 The front of the home is attractive, tidy and safe. There is parking for approximately three vehicles. Some parking is available in the quiet road to the front of the property. The paintwork to some door and window frames outside of the home is in need of redoing and a recommendation is made that this be undertaken. The garden is large and well maintained and is used by the people living there. A coowned home is situated next door and people share gardens to enjoy football games. The Registered Manager agreed to provide a barrier to some steps and surround in the corner of the garden for safety. A broken lock has been replaced on a bedroom door. Bedrooms are completely individual. Some bedroom doors show signs of damage that has been repaired. The doors are not identical and this does not promote a homely environment. The Registered Manager agreed to provide matching door when doors are replaced. Redecoration has been undertaken in several areas since the last inspection and the Registered Manager pointed out other areas where this is planned. The communal areas in the home are clean, tidy and homely. The laundry is clean and hygienic and COSHHE items are kept in a locked cupboard. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 17 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. Recruitment and induction is well managed and staff training is promoted. EVIDENCE: Since the Registered Manager has been back in post he has improved the standard of induction by using the comprehensive format that is provided by the company. The employment procedures in the home are sound and include CRB checks. Regular supervision is undertaken. The Registered Manager stated that he aims for three members of staff to be on each shift team and if this is not possible he will include himself on the rota. A person living at the home was observed undertaking a one to one outing with a member of staff. Communication between staff and people who live in the home was seen to be clear and friendly. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 18 The company has improved the level of training it offers to staff in the past few years and a training matrix for the home includes the mandatory training and specialist subjects such as Equal opportunities, Challenging behaviour, Adult abuse and POVA awareness and Primary prevention training. NVQs are underway and the training matrix indicated that one member of staff has level 3, and eight staff has or are working towards level 2. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 19 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. Management has improved and gives people living in the home the opportunity to voice their opinions. The health and welfare of people is safeguarded by policies and procedures. People benefit from the ethos and leadership of the Registered Manager. EVIDENCE: The acting manager responsible at the time of the previous inspection has since resigned and the new Registered Manager is the then previous manager of the home mentioned in the last report. Management of the home has substantially improved since the last inspection All 17 requirements made at that time have been met. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 20 The Registered Manager discussed his wish to undertake the recommendations made in this report if the company assists with the finance. It is greatly hoped that the company will support the Registered Manager who has made such a contribution to the improvements already made. The company has recently audited the home as part of the annual assessment procedure. People in the home undertake weekly meetings and this is mainly for them to choose the menus for the following week. People who had asked the staff about holidays abroad are to be offered this. The Registered Manager said it would be the first time he and the staff had attempted escorting people abroad, but said they were looking forward to it and thought it would be a good learning opportunity for future holidays. The company also organises regular conferences and a person from each company home, supported by a member of staff, is invited to attend. People are encouraged to offer opinions on their lifestyle in the homes. This is good practice and promotes equality and quality assurance. The Registered Manager ensures that staff follows the policies and procedures of the home and of the company. Staff have induction workbooks and easy access to training. When people returned from their activities at lunchtime they were keen to see the Registered Manager and talk to him about their day. The rapport was friendly and understanding and people had any questions answered in a manner that suited their communication style. Company policies and procedures are sound. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 21 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 3 2 3 3 3 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 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard YA24 Good Practice Recommendations The outside of the home is to be repainted. The kitchen is to be refurbished to provide a homely environment and to include new discrete cupboard locks. Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 23 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 Maple House DS0000023463.V335891.R01.S.doc Version 5.2 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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