Inspection on 26/02/09 for Martins

This inspection was carried out on 26th February 2009.

CSCI found this care home to be providing an Excellent service.

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

Martins 28/02/07

Martins 15/03/06

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Martins 2 Ebbsfleet Lane Ebbsfleet Ramsgate Kent CT12 5DJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Sumner     Date: 2 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Martins 2 Ebbsfleet Lane Ebbsfleet Ramsgate Kent CT12 5DJ 01843823010 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): High Quality Lifestyles Ltd Name of registered manager (if applicable) Mr Michael Harrison Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 2. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disabilities (LD) Date of last inspection Brief description of the care home Martins provides support and accommodation for 2 people with learning difficulties. The home is spacious with a garden at the back and a garage that is used as a workshop. The home is in walking distance from another home owned by the company. There is parking for one vehicle at the side of the home and on street parking in front of the home. Care Homes for Adults (18-65 years) Page 4 of 27 care home 2 Over 65 0 2 Brief description of the care home A car is provided for the people who live in the home to use. The current fees for the service are arranged on an individual basis. Information on the Homes services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The e-mail address of the home is martins@hqls.org.uk Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We telephoned the home to say we were coming today to make sure the person living in the home was not too busy. We came in and said hello to the person living in the home. We talked to the manager and the staff. We talked to the person living in the home. We had a look around. We looked at some of the policies and procedures. Care Homes for Adults (18-65 years) Page 6 of 27 We looked at plans and records for supporting the person living in the home and the staff. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home understands the importance of having sufficient information when choosing a care home. Admissions are not made until a full needs assessment has been carried out and the person has had enough time and support to make a decision. Evidence: One person lives in the home at present. There are plans for another person to move in. The person who lives in the home has been involved in the decision of who moves in. Assessments involve the person and are carried out by different people including the home manager, the care manager or social worker, behaviour support team and community learning disability and mental health services. People have the opportunity to visit the home and have some trial visits before making a decision to move in. The manager said they are planning to design a service user guide to meet the needs of the person who moves in to the home. Care Homes for Adults (18-65 years) Page 10 of 27 Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The key principle of the home is that people using the service are in control of their lives and they direct the service. Evidence: The person living in the home is supported to make his own decisions. He initiates meetings with the staff and manager to discuss different aspects of his lifestyle. Minutes of the meeting are taken and action points agreed. He then signs to say he agrees with them. He also has one meeting a week with the company behaviour consultant. We talked to the person during the visit and he said he is happy with the support he gets from the staff in the home. We looked at the records and everything we saw demonstrated that the person was at the centre of the support in the home. The person living in the home has a person centred plan that includes information to support his communication, how he would like to be helped with personal and health care needs, and what support he needs for his lifestyle. He also has a support plan Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: folder that has more detailed information in about personal, social and health care. This includes risk assessments so that he can be supported to do different things and not be stopped just because they appear unsafe. There are clear guidelines agreed and chosen by the person to safeguard him and enable him to be as independent as possible. We looked at some of the risk assessments including one for cooking. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person living in the home is supported to live an ordinary life in the community in the way he wants to. Evidence: Opportunities for a variety of activities are made available. Additional staff are in the home for activities outside the home. The person living in the home has chosen his own lifestyle and this is supported. His current occupation is a mixture of paid work and time in his workshop. Staff are supporting him to develop his work life and we saw lists and plans for this. At present they are compiling a picture activity timetable. Several photos have been taken of the person in a variety of activities and general home life. He wanted this so that it is clear what he wants to do each day. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: Contact with family and friends is supported. The details needed are in the person centred plan and this indicates who is important and how he wishes to keep in touch. The person living in the home likes cooking and there are guidelines for staff to support this that have been designed by the person with the staff. There are risk assessments with guidelines for managing this activity. They are also taking photos of the meals he cooks for the menus. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use services receive effective personal and healthcare support using a person centred approach. Evidence: The person living in the home has decided how he wants to be supported. He has made sure that guidelines are written down for the staff so that they consistently support him in the way that he wants. We looked at some of the guidelines in his folders and saw that it is very clear what is expected of the staff. Health care is supported individually and there is an individual health action plan. The person living in the home has chosen which health services he wants. He is supported by all the specialist and medical services that he requires. The learning disability team make referrals on his behalf to specialist services should he require them. Medication is given using a monitored dosage system. We looked at the storage and records. The service carries out risk assessments and supports individuals to administer their own medication if they wish to. Care Homes for Adults (18-65 years) Page 16 of 27 Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an open culture and people feel safe and well supported. Evidence: The home has a complaints procedure. The person has the opportunity to raise concerns in one-to-one meetings which he requests whenever he feels the need. We looked at the meeting records and could see that meetings are requested frequently. Lots of different things are discussed and we also saw that when a request is made and agreed to the staff act on it. The person living in the home made comments that indicated that he is well supported by the staff. He also said they are all nice and he just talks to them if needs something. We saw that the ethos of the home is that it welcomes complaints and suggestions and uses these positively. The company has a safeguarding adults policy and whistle blowing policy. The staff are aware of what to do if they suspect abuse. The person living in the home also has meetings with people in the company who are not based at the home. The manager keeps an open dialogue with the local social services safeguarding service and discusses any issues that may need clarification. There have been no safeguarding alerts recently but the home have raised their own alerts before. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is organised to fully meet the needs of the people living there. Evidence: Martins is a service that can provide accommodation and support for two people. We looked around the home and saw that it has been well maintained. The lounge has new curtains. Various parts of the home have been decorated. The person in the home said he chooses the colours and has done some of the decorating himself. The staff told us that there were plans to change the room that is currently being used as an office into a meeting room. There is a spacious conservatory at the back. So there are lots of different areas of the home and grounds that the person can go to do different activities. The person living in the home decides whether to have music playing or TV or just have some peace and quiet. There is a good sized garden at the back and a workshop. The person living in the home also likes to do some gardening. The company employ their own maintenance team who do monthly checks and also visit whenever necessary to carry out essential maintenance. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: The person living in the home has talked to the staff and requested various safety features and arrangements. He is able to live as independently as possible and is able to organise the level of support he needs to live in the home in the way he wants to. Staff have had infection control training and cleaning products are kept securely. The laundry is suitable for the needs of the people living in the home. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are skilled and motivated. The service is organised and staffed so that it is able to support the individuals living in the home in the way they want. Evidence: The small staff team is made up of experienced staff who are confident in their role. The person living in the home is supported by staff he knows. They have worked in other homes in the company and some have worked with the person living in the home before. There is a settled staff team and there have not been many changes to the team since Martins opened. This means that there is consistency in the support provided to the person. No agency staff are used. The company has a thorough recruitment process to make sure the people applying for the job are who they say they are and will work in the right manner. The company asks for identification like a passport and 2 references from people who know the person including their previous employer. They request a Criminal records bureau (CRB) check and protection of vulnerable adults list (POVA) check to make sure they have not done anything in the past that will indicate that they are unsuitable or cannot be trusted. Staff work for a trial period of time in the company while everyone gets to know each other and the member of staff decides whether this is the right job for Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: them. We looked at two staff files and saw that all these checks had been carried out. The person living in the home also interviewed the newest member of staff. Each new member of staff has some initial training using the Skills for Care and company induction training. The person living in the home has assisted with the training for staff and in the development of training for Skills for Care and for the company induction training. We talked to staff. They told us about their role. It was evident through what we saw and what they told us that the person living in the home is in control of his lifestyle. He is supported in the way he wants and he says he is very happy with this. We discussed the training the staff have had and are currently studying. We looked at the training plan and some of the certificates. The manager and senior staff member have just completed the Diploma in positive behaviour support. And one of the senior staff has management qualifications and past experience as a manager. All the staff have a national vocational qualification NVQ and have attended person centred planning training. The newest member of staff is about to start NVQ 2. There is a good range of general training to meet health and safety at work requirements. The staff have meetings with each other and one-to-one meetings with the manager to maintain communication and consistency of working practice. They also have annual appraisals with the manager. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager is highly competent to manage the home based on the organisations values and in the way the people who live in the home want. Evidence: The registered manager of the service has several years experience working with people with learning disabilities and with working with adults who have challenging behaviour. He was worked for High Quality Lifestyles for 12 years and has experience of managing a number of their services. He is currently attending the Tizard centre where he is undertaking a diploma in positive behaviour support. We saw that there is a good rapport between the manager and staff. The manager said he works alongside the staff on shift a couple of times a week to provide peer support and guidance. He also spends time with the person who lives in the home which enables him to make changes to the service which enhances the quality of support that the person receives. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The company have a quality monitoring system in place that has some standards that are monitored and reviewed on a monthly basis. They use an electronic periodic service review system. Surveys can be given to the people living in the home. Surveys can be sent out to families, staff, GPs, nurses and other visiting professionals. The service also has monthly Regulation 26 visits from senior management and receives a report of these visits with actions to be taken identified. There is a development plan for improvements in the home which has been produced with the person living in the home, the manager and the staff. The person living in the home said he could think of nothing that needs to be improved in the service that is being provided to him apart from maybe a new car. All the staff have attended essential training for health and safety law. Where training needs to be repeated and updated this is booked. The person living in the home has also attended some of the health and safety training. The manager carries out risk assessments on the environment and these are reviewed during weekly health and safety walkabouts. There are records of maintenance and safety checks in the home. We looked at the fire safety records and saw that checks are carried out and records are completed clearly. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!