Inspection on 28/02/07 for Martins

This inspection was carried out on 28th February 2007.

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

Martins 26/02/09

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 09/07/2008.

CARE HOME ADULTS 18-65 Martins 2 Ebbsfleet Lane Ebbsfleet Ramsgate Kent CT12 5DJ Lead Inspector Chris Woolf Unannounced Inspection 28th February 2007 09:50 Martins DS0000063650.V328608.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 Martins DS0000063650.V328608.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. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Martins Address 2 Ebbsfleet Lane Ebbsfleet Ramsgate Kent CT12 5DJ 01843 823010 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) High Quality Lifestyles Limited Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th March 2006 Brief Description of the Service: Martins provides support and accommodation 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 for one vehicle at the side of the home and on street parking in front of the home. 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. The current fees for the service are not available. Information on the Home’s 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 Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on evidence gained from information provided and a preinspection questionnaire completed by the service; comment cards completed by the service users and a care manager; and a site visit to the home of just under 4 ¼ hours. The visit included speaking with the service users, staff, and manager; a tour of the premises; observation of life in the home and the interaction between service users and staff; and inspection of a variety of records. What the service does well: What has improved since the last inspection? What they could do better: There have been several changes of manager since the home opened and a permanent manager needs to be appointed to ensure stability and continuity for the service users. It is important that no new member of staff starts to work in the home until the company has received a satisfactory check of the Protection of Vulnerable Adults register. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 6 Some medication recording issues need to be addressed. Although there is informal quality assurance in place, the home needs to develop a formal documented system. A copy of the signed service user contracts should be kept in the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Martins DS0000063650.V328608.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 Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, & 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users and their representatives receive sufficient information to enable them to know what to expect from the home. Individual aspirations, needs and goals are assessed and person centred care plans developed to support individual development EVIDENCE: The service user guide and statement of purpose have both been revised as required on the last report. Comprehensive needs assessments are obtained for potential service users prior to their admission. These assessments help to ensure that the home will be able to meet the healthcare, personal, social, emotional, and cultural needs of the prospective service user. To the question did you receive enough information about this home before you moved in so you could decide if it was the right place for you? one service user comment card included the statement, ‘several visits prior to moving in’. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 9 Currently there are no signed copies of contracts available in the home as these are kept elsewhere, and a recommendation is made that a copy is retained in the home. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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: A comprehensive, person centred care plan is produced for each service user. These care plans are based on information received on pre assessment and are regularly reviewed and updated to reflect any changes in the needs of the Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 11 service user. In addition to personal, healthcare, and specialist needs the care plans include information on preferences and cultural needs and positive behaviour support guidelines. Each service user is allocated their own key worker to give them additional one to one support and guidance. One service user comment card included the statement, ‘I speak to my keyworker’. Service users are enabled to make decisions about all aspects of their daily lives, and choices are made on a daily basis. Where choices are not appropriate discussions take place and compromises are agreed and documented. A good system of risk assessment and risk management is in place supporting individual service users to take the risks that are appropriate to them, and therefore enabling them to lead as independent a lifestyle as their physical and mental health will allow. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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: Currently the home are trying to arrange for both service users to attend college, one to do woodwork and the other basic cooking and baking. At present one of the service users spends most of his time during the working Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 13 week working in the garage that he uses as his workshop, painting or doing woodwork. He also helps the maintenance person to perform his regular monthly checks; helps with general maintenance in the home; helps in the garden; and does his own washing. The service user particularly enjoys helping with the weekly shop, and doing some cooking. Service users enjoy trips to a variety of activities in the local community. A staff member commented, “We take the service users out on a 2 staff to one service user ratio”. Both service users have visits to their own homes, and keep in regular contact with their family and friends on the telephone. Visitors are welcomed into the home. The home keeps in regular contact with service users family and involves them in decisions regarding the care of their family member. Daily routines in the home are flexible and planned around the individual needs of the service users. A care manager comment card included the statement that, ‘The team plan his day around him and his day-to-day needs and abilities to cope. All information regarding changes in passed on to xxxx’. Service users bedroom doors have keys available and one service user explained that he has a key to his room. Activities that take place in the home cooking, internet & computers, garage for DIY, games, televisions in rooms, DVD & Videos. Interactions witnessed between staff and service users were good. Service user comments included, “I do my painting in the workshop”, “I do my own washing and tumble drying”, “I like to go to the pub”; “I help the maintenance man with the monthly checks”; “I talk to my mum on the phone”; “I like to go to the Disco”; “I like to watch the wrestling”; “I have just been out for a walk”; “We are going shopping now”; and “I am going to do some drawing”. Meals are planned on a weekly menu based on the likes and choices of the service users. The main meal of the day is in the evening with lunch tending to be a lighter meal. A staff member commented, “we have a set menu but if the service users want anything different they just ask and they can have what they want”. Service users are weighed regularly but staff need to be more disciplined about the recording of these weights. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal and healthcare support of service users is planned and delivered individually, with appropriate support from both staff and health care professionals to promote physical and mental well being Medication is securely stored but some recording issues need to be addressed to fully protect service users. EVIDENCE: Personal support of service users is given in line with their individual needs and choices, and as assessed and recorded in their personal care plans. Times for getting up/going to bed, baths and meals are all flexible. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 15 Healthcare support from various specialists is accessed as needed and all appointments are documented. The home promotes the service users physical health by regular exercise, and their emotional health through regular meetings with staff. Following the last inspection report the storage area for medication has been moved to a more appropriate area where there are no problems with the temperature; drug storage is secure. Up to date medication policies are in place. Currently neither of the service users are self-medicating, one commented, ‘the staff give it to me’. There were omissions on the recording of medication received in the home on the medication sheets; the registered person is aware of this and is in the process of ensuring that all staff are aware of and carry out the correct procedures, therefore a recommendation has been made regarding this. All staff who administer medication have received appropriate training to perform this task. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their representatives can be assured that any complaints and concerns they raise will be taken seriously and acted upon. The company will act appropriately to ensure that service users are protected from abuse. EVIDENCE: The home has a clear complaints policy and procedures. No complaints have been received by the home since the last inspection. To the question ‘do you know who to speak to if you are not happy’ one service user comment card had the answer ‘I speak to my keyworker and other staff and the manager Mike’, however the same comment card answered the question - do you know how to make a complaint, with the reply, ‘No I don’t’. Although a copy of the complaints procedure was available in the office, one has also now been put on display in the home. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 17 There is an open Adult Protection Alert currently on the home. The company followed all of the correct procedures very promptly, and they raised the alert with Social Services. The company have also made a referral to the POVA list. Staff spoken to during the site visit indicated their awareness of adult protection issues and were aware of the actions to take if they suspected potential or actual abuse. The homes policies and procedures for the handling of service users monies have been tightened up and are now of a satisfactory standard. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides individual bedrooms with colours and furniture that are chosen by the service user, encouraging ownership and independence All communal areas are clean, bright, comfortable, and well maintained, and meet service user needs EVIDENCE: The premises are safe, and well maintained. The company employ their own maintenance team who do monthly checks and also visit whenever necessary to carry out essential maintenance. There is a contract for carpet cleaning and this is done monthly. The carpet in the lounge/dining areas is scheduled for replacement in April. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 19 Communal space consists of a lounge/dining area, a conservatory, a kitchen a laundry area, and a W.C. On the first floor there are two service user bedrooms, a sleep in room, and a bathroom. There is a garden at the rear of the property and a garage that is used as a workshop by one of the service users. One of the maintenance staff commented, “xxx helps me with the maintenance checks each month. We are having a new carpet in the lounge and dining area but the carpets are cleaned once a month anyway”. One service user showed the inspector his bedroom, which was comfortable and contained his own personal belongings. He commented, “I painted the room, but the border still has to be put up”. Bedroom doors are lockable, and there is a nurse call system fitted in each bedroom Furnishings and fittings throughout the home are appropriate to the needs of the service users. The home is clean and hygienic, with no unpleasant odours. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users could be put at risk by the company not obtaining a check of the Protection of Vulnerable Adults register prior to staff being employed in the home. Staffing levels and training ensure sufficient, appropriately trained staff are on duty at all times to meet the assessed needs of the service users. EVIDENCE: 70 of the staff working in the home have achieved NVQ at level 2 or 3. All new staff receive induction training, and the training matrix indicates that the majority of staff are either up to date or that training is already planned. All staff undertake training in strategies for crisis intervention and prevention. Currently the company do not offer Learning Disability Awards Framework training to the staff and a recommendation is made regarding this. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 21 Sufficient staff are on duty in the home to meet the assessed needs of the service users with additional staff during the busiest part of the day. When service users go out of the home they are accompanied on a 2 staff to 1 service user ratio. At night there is always one waking and one sleep in staff. The manager also gets involved in the day to day running of the home, particularly when service users wish to go out into the community. The home do employ agency staff from time to time but only use one company and wherever possible try to ensure that the same people are used to ensure continuity for the service users. The company obtains 2 satisfactory references for all employees and submit a Criminal Records Bureau application prior to staff starting work. However, although new staff are employed under supervision until their CRB check is received, the company do not wait until the CRB enhanced disclosure is received or obtain a satisfactory check of the Protection of Vulnerable Adults register prior to staff commencing employment. A requirement is made regarding this. General Comments made by staff included, - “I love it here”, and “I had induction training before starting”. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users would benefit from the consistency of stable management. The home is run in the best interests of service users and their health and safety are protected. EVIDENCE: Currently the responsible individual is very effectively managing the home and working hard to address all of the shortfalls that have been discovered. However, there have been several changes of management in the short time this home has been registered, which is disruptive to the lives of the service Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 23 users. The company are currently recruiting a new manager and service users are involved in the interviewing process. A recommendation has been made that the home continues with its plans to appoint a permanent, qualified and experienced registered manager for the home in order to ensure consistency for the service users. Being a small home consultation with service users, their families, and their care managers takes place regularly and on an ongoing basis. However a formal documented quality assurance still needs to be developed, therefore a recommendation has been made regarding this. The health, safety and welfare of both service users and staff are promoted by the home. Risk assessments are carried out for any actions that could put service users or staff at risk. Statutory training is undertaken by all staff and is either up to date or refresher courses are planned. Security of the premises is good. All equipment maintained is serviced regularly. Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 2 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 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 1 35 2 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 3 X Martins DS0000063650.V328608.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? No. 1 Standard YA34 Regulation Requirement 19(5)(d)(i) A satisfactory check of the Schedule Protection of Vulnerable Adults 2 (7) (a-b) register must be received before any new member of staff commences work in the home. Timescale for action 14/03/07 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 4 5 Refer to Standard YA5 YA20 YA35 YA37 Good Practice Recommendations Signed copies of service users contracts should be kept in the home. The recording of medication must be in line with the guidelines set by the Royal Pharmaceutical Society Staff should be encouraged to attend Learning Disability Awards Framework training. The company should continue with their plans to appoint a permanent, experienced and qualified registered manager for the home. The company should further develop its formal quality assurance strategies. 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