Inspection on 18/05/05 for Mariners Folly

This inspection was carried out on 18th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Mariners Folly 03/07/07

Mariners Folly 29/12/06

Mariners Folly 15/06/06

Mariners Folly 25/10/05

Mariners Folly 12/10/04

Mariners Folly 14/04/04

Similar services:

Lyncol House

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Mariners Folly 194 Parrock Street Gravesend KENT DA12 1EW Lead Inspector Eamonn Kelly Unannounced 18 May 2005 12.30 pm 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. Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mariners Folly Address 194 Parrock Street Gravesend Kent DA12 1EW 01474 361935 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) Dharshivi Limited Care Home 13 Category(ies) of Learning Disability (13) registration, with number of places Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12 & 13 October 2004 Brief Description of the Service: Mariners Folly provides care and accommodation for up to thirteen people with learning and some physical disabilities. The Statement of Purpose and Service User’s Guide describe the range of services and facilities provided and the aims and objectives of the home. Each service user has a single bedroom. A range of opportunities for personal development, leisure and work inside and outside the premises is provided and service users have access to all medical and other facilities. There is good communal space within the premises to enable service users to practice pastimes and activities. Twenty-four hour care and supervision is provided. Two members of staff are on duty at night (one awake and one asleep) and the manager and owner are available “on-call”. The home is situated in the centre of the town and, accordingly, there is ready access to public transport and a wide range of amenities including the promenade and riverfront. There is a private car park at the rear of the premises. The home has a small patio area at the rear. Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was made on 18 May 2005 during which seven service users were met. Dental nurses visited 3 residents on the day. The manager and owner were present. Each of the bedrooms was visited as part of the inspection as were communal areas of the premises. A check of some of the home’s records was made. What the service does well: What has improved since the last inspection? What they could do better: The home has made very good progress in establishing a safe and comfortable environment for residents, where thoughtful and effective management and Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 Page 6 new procedures are contributing to the well being of service users and good job satisfaction amongst members of staff. No particular areas were identified on this occasion where improvements were recommended. 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. Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 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 Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 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) 1, 2, 3, 4 & 5 The home has a good admissions procedure which is effective in assessing whether prospective service user’s care needs and aspirations are likely to be met. EVIDENCE: The home has a good service user’s guide/statement of purpose. A detailed admission process is followed to try to ensure that persons newly admitted are likely to receive the levels of care they need. Members of staff have a detailed knowledge of the care needs and aspirations of service users. New service users receive appropriate care and attention, including pre-admission assistance and support. Each receives a personal contract. Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 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, 7, 8, 9 and 10. Care planning and recording systems which reflect the current needs of service users and their specific aspirations are in place. There is commendable emphasis on identifying and recording changing needs of residents based on observation, review and enabling them to actively participate in making decisions. EVIDENCE: Members of staff have easy access to computerised care plan records (those seen were up-to-date and reflected the personal and healthcare needs of the residents to whom they referred). Each resident had an individual plan which set out agreed objectives and goals to be aimed for. There were examples in each case of risk assessments associated with the activities and routines of residents. The home has a policy of confidentiality of records and information (which enables residents to see and contribute to records relating directly to them). Meetings with service users and members of staff strongly indicated that residents make decisions about their lives and that there is considerable insight into how suitable support and guidance is provided to ensure that counselling and advice is fully appropriate in each case. Regular staff/resident Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 Page 10 meetings are held and the views of service users are obtained (minutes of meetings were made available). Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 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, 15, and 16. Residents have a wide range of opportunities within and outside the premises and have good contact with the local community. EVIDENCE: Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 Page 12 Some service users have paid employment. Others attend College and have a range of activities or routines within and outside the home. All have a great deal of contact with the local community. Examples of a variety of activities were discussed (including preparations for a play/performance involving service users to be staged in November at an external location still to be identified). There is participation in local fund-raising. One or more members of staff are always at the home to assist service users who are unable to attend longer-term external activities (eg. day centre activities) but who need in-house support and shorter-term outings (eg. to local amenities). Each service user is assisted to maintain family links and other friendships [the contacts are monitored (with agreements recorded following care reviews) to assist service users benefit from such contacts]. They receive support and counselling with assistance from care managers and others as necessary. There is a weekly menu rotated over 4 weeks. Special diets are followed for some service users (with access to dietician advice). All members of staff who prepare food either have or are scheduled to undertake a food hygiene course. There was evidence that some service users who had not shown improvement for a long time had made discernable advances in recent months. Some residents go out unaccompanied while others always have supervision. Holidays are planned for later in the year (to supplement day breaks and shorter outings). Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 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) 18, 19, 20 Very good support is provided for residents in relation to emotional and physical needs and healthcare services. EVIDENCE: Assisted by a key worker method of working (with agreed rotation of key workers), members of staff provide personal support as needed by each service user (current and changing needs are recorded in service user care plans). There is good access to healthcare facilities. The intervention of a speech therapist has, according to members of staff, been of specific benefit to some residents (this progress has been remarkable). Dental nurses were visiting (which helps to alleviate stress for some service users). Service users have an allocated care manager and care plan records contained the results of their care reviews. Service users visit an optician and are accompanied by a member of staff. Residents have access to GP, community practice nurse, and other medical services. The services of a bereavement counsellor have been obtained. Improvements to the medication system (recommended by the CSCI pharmacist at the previous inspection in October 2004) have been put into effect. Some residents maintain their own medication and recorded risk assessments suggest that they are able to do so safely. Training for staff in Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 Page 14 medication administration is provided. Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home has adequate measures in place to protect residents and residents are aware of the general measures. EVIDENCE: Records of incidents are kept at the home. Reports are made to the CSCI of all notifiable incidents. All members of staff have been checked under appropriate recruitment procedures now in force nationally. The home follows the Kent & Medway Policy for Adult Protection. A complaints procedure is in place and service users are aware of this because some have, from time to time, requested to see the CSCI inspector. Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 Page 16 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) 24, 25, 26, 27, 28, 29 & 30. Bedroom and communal facilities are suitable for the current needs of service users. EVIDENCE: The premises are a large building in the town centre and are suitable for the needs of current service users. Bedrooms (located over 3 floors) are suitable for the needs of service users. There are very good bathroom facilities (6 WC’s, 2 bathrooms and 3 shower facilities). There are sufficient shared spaces (on the ground and basement floors) for service users, members of staff and visitors. Members of staff have a programme of daily/weekly maintenance of bedrooms and, in some instances, residents assume responsibility for keeping their rooms clean and tidy. There are no specific adaptations or disability equipment (other than availability of wheelchairs for outings). The manager stated that any adaptations needed would be identified during reviews and such equipment as necessary would be obtained. The premises were clean throughout and very well maintained. Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 & 36 The home has a training programme which (based on discussions with staff and meetings with service users) meets the needs of service users. EVIDENCE: The manager has recruited a number of new members of staff and there was evidence that each has the benefit of a structured induction programme. Five members of staff are currently undertaking NVQ Level 2 in Care and the stated intention of the home is to provide this course to all who wish to complete it. The statement of purpose outlines the specific training undertaken by all members of staff. Improvements have also been made in the staff supervision process which increasingly concentrates on meeting areas of knowledge and skill agreed as necessary in understanding the needs of service users with complex conditions and changing aspirations. Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 Page 18 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) 37, 41 and 42 Service users benefit from a well run home where the health and welfare of service users is effectively promoted. EVIDENCE: The manager has completed NVQ Level 3 in Care and is well advanced on the Registered Manager’s Award. The computerised care plan record system (the assumption based on the examples checked) provides a good basis for identifying changing health and welfare needs and recording these for the benefit of key workers and others. The review of records and the updating of some to make them effective operational tools have enabled staff and service users to benefit from a well run home (another example was the revised medication records which members of staff indicated were more effective than previously). All visitors sign in and out. Aspects of security have been improved at the front and rear of the premises. There is a good staffing ratio on duty at night and other members of staff are available on-call. Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 Page 19 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 4 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 4 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mariners Folly Score 3 4 4 x Standard No 37 38 39 40 41 42 43 Score 3 x x x 3 3 x H56-H06 S50495 Mariners Folly V226992 180505 Stage 4.doc Version 1.30 Page 20 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 Regulation None 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 None Good Practice Recommendations Mariners Folly H56-H06 S50495 Mariners Folly V226992 180505 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. 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