Inspection on 30/05/06 for Marshlands

This inspection was carried out on 30th May 2006.

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

Marshlands 25/06/08

Marshlands 19/12/05

Marshlands 31/05/05

Marshlands 23/03/05

Marshlands 12/07/04

Marshlands 22/01/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Marshlands Dennes Lane Lydd Kent TN29 9PU Lead Inspector Wendy Gabriel Unannounced Inspection 30th May 2006 10:00 Marshlands DS0000023599.V297086.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 Marshlands DS0000023599.V297086.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. Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Marshlands Address Dennes Lane Lydd Kent TN29 9PU 01797 320088 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) Park Care Homes (No 2) Ltd Ms Claire Stephanie Levy Care Home 20 Category(ies) of Learning disability (20) registration, with number of places Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th December 2005 Brief Description of the Service: Marshlands is a spacious, detached, Edwardian property set in a rural location on the outskirts of Lydd, on Romney Marsh. The home overlooks farmland and has views across the Marsh. The house is set in its own extensive grounds, which are actively used by the Service Users with staff support to grow vegetables and keep chickens for egg production. Access to the town of Lydd is possible by foot, approximately a 15 minute walk or very short car journey. Public bus transport is available from the main route through Lydd, however the home has access to several vehicles. The home is owned and operated by Park Care Homes (No2), Ltd (a Craegmoor Healthcare company), and is managed on a day-to-day basis by Ms Claire Levy. The home is registered to provide care and support to a maximum of 20 Service Users, however this number entails the use of double bedrooms, therefore the number of Service Users currently supported is 16; the Registered Manager stated this is the maximum number of Service Users Bedrooms are located on two floors (ground and first) and one resident has a self contained flat. The home has one bathroom, three shower rooms, and 5 toilets for communal use. Communal space includes a large lounge, a separate smaller lounge, a small computer room, and a conservatory, which can be used for smoking, a kitchen, and laundry. Additional recreational space on site is available by way of a detached day service room that has a table tennis table, art and craft facilities and a small kitchen where residents are able to make hot and cold drinks and do their ironing with staff support. The fees range from £800.00 to £1700.00 per week. Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was fully staffed and noted to be clean, tidy and hygienic. Service Users were accessing various parts of the home and were friendly and welcoming to the Inspector, some of them allowing her to view their rooms. Requirements made at the previous inspection had been met. Some recommendations were made at this site visit. The Registered Manager was due to employ a dedicated activities person who would run the day centre in the grounds with the intention of being able to offer more choice to Service Users. What the service does well: What has improved since the last inspection? What they could do better: A recommendation was made at the previous inspection for a protocol to be written regarding homely remedies had not yet been met as the Registered Manager said no Service User was currently using any. The Registered Manager was able to clearly express what would be required in the document and another recommendation was made for his to be done. Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 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. Marshlands DS0000023599.V297086.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 Marshlands DS0000023599.V297086.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The home is meeting the aims of the current statement of purpose EVIDENCE: The Registered Manager confirmed that the pre admission assessment would include visits to the prospective Service User in their own environment and visits to the home including overnight stays to get used to the environment and for staff in the home to assess needs. The company has recently provided a new pre admission assessment document viewed by the inspector that indicates needs and choices. Care managers and other involved parties will be included in the assessment process. Referrals would be made to health care professionals as required. Marshlands DS0000023599.V297086.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents are enabled to maintain their health care and lifestyle choices and risks are identified to support this. EVIDENCE: A requirement and recommendation made at the previous inspection for the care plans to contain goals and to be dated has been met. The Registered Manager has previously stated that the care plans will all be reviewed using the person-centred approach by the end of 2006. This is well on the way to being met. Those care plans seen that had been reviewed, included user friendly documents that detail ‘hopes and dreams’ and goals of the individual Service Users. One had information written in it by the Service User indicating personal choice. The Registered Manager and Deputy Manager said that creating the person-centred plans and assisting Service Users to identify their goals had pleasantly surprised the staff by how simple some of the goals had been to meet. Key workers write a monthly report and annual reviews are held. There is a good risk assessment procedure. Risks are assessed and have action points to help staff give the appropriate support towards enabling residents overcome individual risks. Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 10 Marshlands DS0000023599.V297086.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Service Users are offered a daily choice of educational and leisure activities. Meals are provided that meet dietary needs and choices. EVIDENCE: There is a daily staff handover that identifies Service Users planned activities and staff actions for maintaining appointments. This offers a supported framework for Service Users to make choices that can be enabled by the team of staff on duty. There are three staff teams in the home each led by a senior support worker in addition to the Registered Manager and Deputy Manager. Each Service User has an individual day care plan. 7 Service Users attend college, 1 attends a work placement and all may access the day centre in the grounds of the home. The Registered Manager is due to employ a dedicated day centre activity co-ordinator with the intention of assisting all Service Users have a better opportunity for making choices. A kitchen is in the process of being completed in the day centre where the Registered Manager plans for Service User to learn life skills such as making their own drinks and lunches Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 12 with support from staff. Several Service Users happily showed the inspector their pets in the grounds including rabbits and guinea pigs and told her all about the care of them. The homes own chickens roam the grounds and visiting peacocks and mallards with ducklings from the nearby stream also regularly wander in the garden. One Service User showed the inspector the patch where there was evidence of a selection of vegetables growing. Another Service User delightedly pointed out the ducklings to be seen at the end of the garden. Service Users were seen accessing different areas of the home. A support worker was using the main kitchen with a Service User at lunchtime and other Service Users were in the dining room where a member of staff was on duty. The food storage included a wide selection of fresh vegetables and fruit and the menus indicated that fresh food is regularly provided. There was evidence that the advice of a dietician had been sought for one Service User who had since been ‘signed off’. The Registered Manager said staff were trying to encourage a wider variety of foods and to be less ‘traditional’ to give Service Users more scope for choice. Marshlands DS0000023599.V297086.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Personal support is well documented to suit the individual. Trained staff undertake medication administration and safe practices will be improved by the addition of a written protocol for when homely remedies are in use. EVIDENCE: The Registered Manager has put together a pack of all the homes policies regarding medication administration and all staff sign to confirm they have read and understood this. A letter from the G.P. was in place for those Service Users who had previously used homely remedies. The Registered Manager said that currently no Service User was using a homely remedy and fully described the protocol that would be provided should this occur. A recommendation is made that the protocol be written in readiness for such a situation. A recommendation for this was made at a previous inspection. The medication storage is in a secure situation and the Registered Manager and the Deputy Manager confirmed that two members of staff always undertake medication administration. Service Users individual personal support requirements are assessed and recorded, enabling staff to meet their needs. Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 14 Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Service Users know how to complain and are supported to do so by the homes practices if their communication is limited. Staff are aware of the adult protection process. EVIDENCE: There is a complaint protocol in place. Staff undertake a robust adult protection module during their induction. Staff are aware of reporting abusive practices and it is encouraging that some staff have previously raised an alert regarding adult protection this year that has now been satisfactorily concluded. A key worker system enables Service Users to express any dissatisfaction and care managers will be informed of any situation the home cannot resolve. Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 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 the following standard(s): Quality in this outcome area is good. The home is comfortable and spacious and meets the needs of the Service Users living there. EVIDENCE: There was evidence of redecoration going on in the home including public areas and some resident’s bedrooms. Several Service Users kindly allowed the Inspector to view their rooms. These were seen to be highly individual and decorated in a way that the Service Users indicated was their own choice. Bathing and toilet facilities were adequate for the size of the home. The home is registered for 20 but currently has 16 Service Users living there and the Registered Manager confirmed this would not be exceeded. The home was clean and tidy and hygienic at the time of the visit. The day centre is a great benefit to the Service Users and had a variety of equipment for activities. The employment of a full time, dedicated activities organiser will be a useful addition to the staff team. There is a dedicated driver employed for outings and appointments. A mini bus and a car are available for Service Users outings. Service Users were able to communicate that they enjoyed living in the home and were pleased to show the Inspector around the large garden and parts of the home. Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 17 Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The company recruitment policy follows good practice. The new staff induction package is robust and supports staff to understand the needs of learning disability support requirements. EVIDENCE: The recruitment protocol of the company is robust and a previous recommendation to follow up written references with a telephone call has been met. The Inspector recommends that the telephone calls be formally recorded in the recruitment documents as currently they are brief and hard to locate. The Registered Manager discussed the difficulties of obtaining a full working history of some staff who perhaps had not worked for many years due to family commitments, but that this would be sought for new staff applicants. Staff receive a detailed employee handbook that includes information of training and development. Details are also included of supervision and personal performance reviews. A new and robust induction package is in place and used for all new members of staff. It is in line with sector skills council. There was evidence of staff training that week for POVA, CPR and for Understanding Diabetes the following week. The Registered Manager confirmed that the company is good at providing training courses and that new staff do not have to wait too long before statutory training is given. A member Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 19 of staff said that if someone expressed an interest in a specialised course, the Registered Manager would be prepared to seek something suitable. The Inspector was also told that ‘its good to work here’ and that the ethos of the work is Service User centred. Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The home undertakes quality audits for the environment that protect the health and safety of the Service Users. EVIDENCE: ‘Inspecting for better lives’ is the new inspection procedure for the csci and the onus of the inspection will be for the home to gather Service User views and incorporate them into the homes development plan. The company has recently provided a quality assurance profile for different areas of the home. The most recently completed audit was for health and safety, undertaken in April 2006. An annual families and Service User questionnaire is undertaken and the Registered Manager believes that one is soon to be undertaken for this year. No evidence of the questionnaires was available at the time of the visit. A recommendation is made that these and the company responses be made available for viewing. Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 21 The Registered Manager told the Inspector that there are conferences held where one Service User, supported by a member of staff will represent each of the company homes in the area. Their views taken will be taken seriously. Residents hold meetings and evidence of these was seen. The use of the ‘person centred plans’ as previously discussed, will aid the procedure as they are helpful for those Service Users with communication difficulties. Environmental systems certificates were in place. Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 23 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 2 3 YA20 Refer to Standard YA34 YA39 Good Practice Recommendations Telephone references to be formally recorded. The results of family and Service User questionnaires and any responses to be made available for viewing. A protocol is to be written for the use of homely remedies. Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Marshlands DS0000023599.V297086.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!