Inspection on 15/03/06 for Martins

This inspection was carried out on 15th March 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Martins 26/02/09

Martins 28/02/07

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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 Martins 2 Ebbsfleet Lane Ebbsfleet Ramsgate Kent CT12 Lead Inspector Brenda Pears Announced Inspection 15th March 2006 09:30 Martins DS0000063650.V282662.R01.S.doc Version 5.1 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 Martins DS0000063650.V282662.R01.S.doc Version 5.1 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. Martins DS0000063650.V282662.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Martins Address 2 Ebbsfleet Lane Ebbsfleet Ramsgate Kent CT12 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) Care Home 2 High Quality Lifestyles Limited Category(ies) of Learning disability (2) registration, with number of places Martins DS0000063650.V282662.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: Martins provides support and accommodaton for 2 service users with learning difficulties. The home is spacious with a small enclosed rear garden and is also in walking distance from another home in the same group. There is parking to the front and to the side of the home and although it is not in a central residential area, transport is available and outings and shopping trips are regularly undertaken following completion of risk assessments Martins DS0000063650.V282662.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the inspection process consisted of speaking with the acting manager, staff members and both service users. The methods of inspecting the home included checking records, tracking service user care plans, examining staff files, observations and a tour of the building. What the service does well: What has improved since the last inspection? What they could do better: Medication is securely stored but external and internal medication must be stored in separate areas and temperatures must be regularly checked and recorded. The Service User Guide must be in an appropriate format to ensure service users are empowered. Discussions were undertaken regarding these documents and ensuring the full involvement of both service users. Money is retained securely for service users and the minimum amount of staff are involved in these processes. Discussions were undertaken regarding the need for 2 signatures at all transactions of any type. Martins DS0000063650.V282662.R01.S.doc Version 5.1 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. Martins DS0000063650.V282662.R01.S.doc Version 5.1 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 Martins DS0000063650.V282662.R01.S.doc Version 5.1 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): 1,2 The Statement of Purpose and Service User Guide have been produced but both documents require additional information and some development. Individual aspirations, needs and goals are assessed and person centred care plans developed to support individual development. EVIDENCE: A Service User Guide has been developed but this document must be in an appropriate format to ensure service users are empowered. Discussions were undertaken regarding these documents and ensuring the full involvement of both service users. Assessments are carried out prior to a service user being admitted to the home. This assessment and discussions undertaken with the prospective service user, care manager and/or any family members ensures the home can meet the needs of each person admitted. All wishes and hopes for future development, enjoyment and experiences are contained in each personal plan. Martins DS0000063650.V282662.R01.S.doc Version 5.1 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): 6,7,9 Service users are consulted about all aspects of their life both inside and outside of the home. Support is given to ensure risks are taken safely and that individuals become as independent as possible. Those living in the home are consulted on a daily basis about daily routines, events and scheduled activities, supporting autonomy and independence. EVIDENCE: Service users are supported and encouraged to make decisions on a daily basis. The routines of the home revolve around the needs and requests of each person. This was demonstrated by the actions of service users at this time when constantly discussing events that had taken place or that have been planned. The acting manager and staff responded positively, expressed a good knowledge of the routines of each person and gave each service user time for full discussions to be undertaken about each proposed event. The inspection was halted when necessary to ensure each person had the full attention of staff. This supported the service user’s wishes, showed respect for decision making and full involvement at all times. Martins DS0000063650.V282662.R01.S.doc Version 5.1 Page 10 During discussions with one service user at this time, it was confirmed that service users are enabled and supported to make decisions and make plans for the future. Martins DS0000063650.V282662.R01.S.doc Version 5.1 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): 12,13,15,17 Service users undertake appropriate and suitable activities both in the home and in the local community, supporting personal development and autonomy. Family and appropriate personal and relationships are supported. Service users enjoy a varied and nutritious diet that is chosen by individuals with support and guidance from staff, ensuring good health and personal choice. EVIDENCE: Contact with friends and family are encouraged and supported by staff in the home. Reviews of person centred plans are undertaken regularly and discussed with service users, care managers and family members. Both service users telephone their family twice a day, one family visits the home on a weekly basis and trips to families are enjoyed regularly, providing important routines for both service users. Menus and records of food provide evidence of a varied and nutritious diet. Service users choose what meals they will eat and also help with the Martins DS0000063650.V282662.R01.S.doc Version 5.1 Page 12 preparation of food. Many meals are home made and staff also encourage snacks that are healthy. One service user is currently being encouraged to take note of how much is being eaten and to make healthy choices to help with weight loss. Both service users eat meals together and also choose where they eat and if they wish to eat alone, this is again supported. Daily log books have a record of all meals that are eaten and fruit is readily available for snacks between meals. Routines are still being developed following a settling in period for both service users. Activities are currently being undertaken on a daily basis, depending on the choices made by each service user and regular routines are being developed when activities or outings have been enjoyed. One service user was taken shopping at this time and was excited about the purchases that were to be made. Staff encouraged and supported discussion about the outing and the service user appeared confident and comfortable with sharing information with the inspector. Martins DS0000063650.V282662.R01.S.doc Version 5.1 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): 19,20 All support is regarded and delivered as very individual, with appropriate support from both staff and health care professionals to support well being. Medication is securely stored but some adjustments are needed to fully comply with guidelines set by the Royal Pharmaceutical Society. EVIDENCE: Service user needs are met by staff and records confirm that all external healthcare support is accessed and provided as needed. Staff are trained to support service users and in particular with regard to one service user who has previously had some extreme behaviours. Medication is securely stored but external and internal medication must be stored in separate areas and temperatures must be regularly checked and recorded. The area in which medication is currently stored is subject to extreme temperatures and this was discussed in some depth. An alternative storage area must be identified to ensure appropriate storage of medication. Martins DS0000063650.V282662.R01.S.doc Version 5.1 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 the following standard(s): 22,23 Service users are consulted about all events in the home and routines are centred on both service users, supporting autonomy. EVIDENCE: There is an open and transparent working environment within the home. Respect is demonstrated for the needs of others by both staff and service users. Keys are issued to service users where appropriate, following risk assessments and discussions. Observations at this time confirm that service users are confident and comfortable when approaching staff and were also fully included in discussions at this time. The development of an appropriate Service User Guide will also support service users with any matters they need to discuss. Money is securely retained for service users and the minimum amount of staff are involved in these processes. Discussions were undertaken regarding the need for 2 signatures at all transactions of any type. Consideration should also be given to working towards each service user developing some responsibility regarding handling money. This has been the case for one service user who has saved for a new music system and this responsibility could now be developed further. Martins DS0000063650.V282662.R01.S.doc Version 5.1 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 the following standard(s): 24,25,26,28,30 The home provides individual rooms with colours and furniture that are chosen by the service user, encouraging ownership and independence. All communal areas are clean, bright and comfortable and meet all service user needs. EVIDENCE: The home is relaxed and comfortable with service users coming and going as they wish in all areas. The home consists of a large lounge, dining area and with a large conservatory looking onto the small, secluded rear garden. There is space to the side of the building for parking and also a large garage. The garage is used as a workshop by one service user who enjoys working on projects such as painting furniture and working with wood. All bedrooms are individual, furniture is chosen by the service user and each room contains personal possessions. One room has a new sound system that the service user was clearly proud to have purchased. Following support and encouragement from staff, the service user had managed to save for some weeks and buy the system of his choice. All rooms are well maintained by each service user and present individual and comfortable living areas. Martins DS0000063650.V282662.R01.S.doc Version 5.1 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 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): 32,35 There is a training matrix in place to ensure refresher and core training is current, ensuring staff have appropriate skills to support service users. EVIDENCE: Staff on duty at this time consisted of the acting manager, one senior positive behaviour coach and a support worker. There is also one mid shift support worker to cover the end of one shift and the first part of the oncoming shift, providing extra assistance where needed at these busy times of the day. There is one sleep in member of staff plus one waking night staff member. The manager works mainly 9am to 5pm shifts and is not on the care rota as such but does work closely with the staff team and service users. Both service users appeared comfortable when speaking to all members of staff and also when entering the office area to ask questions. There is an induction programme in place and a training matrix showed training that has been undertaken plus dates when refresher training is due. Staff expressed a thorough knowledge of both service user needs and previous history with staff working closely with families to establish regular visits and continued contact. Martins DS0000063650.V282662.R01.S.doc Version 5.1 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 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): 37,39,42 The manager operates an open door policy for staff and service users, encouraging inclusion and independence at all times. Service users benefit from a clearly defined staffing structure that enables service users to feel supported at all times. The best interests of both service users are at the centre of all routines in the home. EVIDENCE: The acting manager has worked for High Quality Lifestyles for 3 years and recently moved from the neighbouring home of Ebbsfleet House to Martins on a trial basis. The organisation has provided good support for the acting manager and 2 established home managers are overseeing Martins and providing additional support. The need for regulation 37 incident reports to be forwarded to CSCI was discussed in some depth. The acting manager explained that reportable Martins DS0000063650.V282662.R01.S.doc Version 5.1 Page 18 incidents had stopped since both service users had settled into Martins. The fact that staff are now fully aware of triggers and are specifically working with one service user who is still grieving the loss of a close family member, has helped to provide a stable environment. The manager explained how to support the person who is grieving and how certain aspects of conversation should be dealt with during the inspection. This provided important information on how to communicate appropriately with this service user and ensured this person would not be upset. This again evidenced the consideration given to both service users and confirmed that inclusion and well being is fully supported. Each service user is supported with appropriate routines that provide a stable environment at all times. Both service users have come to respect each other’s needs and currently live comfortably together. All routines are developed to accommodate service user needs and both appeared comfortable and confident when speaking to the inspector at this time. Martins DS0000063650.V282662.R01.S.doc Version 5.1 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 Standard No Score 1 2 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 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 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 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 2 x 3 X 3 X X 3 x Martins DS0000063650.V282662.R01.S.doc Version 5.1 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 YA1 Regulation 4&5 Requirement That the Service User Guide and Statement of Purpose be developed in line with guidelines and in an appropriate format to support service users. Timescale for action 30/06/06 2 YA20Y 12, 13, 16 That medication is retained in line with guidelines set by the Royal Pharmaceutical Society, with particular regard to acceptable temperatures. 12 & 13 To ensure that 2 signatures are recorded on all money transactions. 30/04/06 3 YA23 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Martins DS0000063650.V282662.R01.S.doc Version 5.1 Page 21 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 Martins DS0000063650.V282662.R01.S.doc Version 5.1 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. 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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