Inspection on 20/06/05 for Northwood House

This inspection was carried out on 20th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Northwood House 30/09/09

Northwood House 28/09/07

Northwood House 03/10/06

Northwood House 27/02/06

Northwood House 17/01/05

Northwood House 07/09/04

Northwood House 22/01/04

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

CARE HOME ADULTS 18-65 Northwood House 28 London Road Sittingbourne Kent ME10 1NA Lead Inspector Robert Pettiford Anne Butts Announced 20 June 2005 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Northwood House Address 28 London Road Sittingbourne Kent ME10 1NA 01795 472464 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Kent Assessment & Training Service (Swale) Ltd Care Home 7 Category(ies) of Learning disability registration, with number of places Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17 January 2005 Brief Description of the Service: The Home is a detached property with accommodation for service users on two floors with office/staff room accommodation in the third floor. The home is registered for seven service users. Excluding the Manager, the Home employs full/part time care staff who work a rota which includes one staff member working at night on waking duty with a further staff member on-call sleeping at the neighbouring Home (Westdene) which is also owned by K.A.T.S. Ltd. A further senior staff member is available on-call in an emergency. In addition to care staff there is a staff member who undertakes cleaning duties.The Home offers services for people with learning disabilities who may challenge the service. The Acting Manager undertakes management of Westdene in addition to Northwood House. Northwood House and Westdene are homes situated on the same site and the administration arrangements are undertaken in Northwood House. Although both homes have defined staffing groups, staff from each of the homes have worked in the other home when required, and staff emergency on-call at night has been provided through the sleep-in staff member at Westdene.Inspection of Northwood House was undertaken on the 20th June 2005, which is the subject of this report. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced Inspection of Northwood House took place on 20th June 2005 at 9:00am. Northwood House is one of two homes owned by K.A.T.S. Ltd in London Road Sittingbourne along with no 26. The homes are detached with 28 and 26 sharing their back gardens.The Inspector agreed and explained the inspection process with the manager and discussed the ethos and values of the home. Documentation and records were read, including care plans. Time was spent reading a sample of written policies and procedures, reviewing care plans, evidencing maintenance certificates and records kept within the home. A tour of premises was undertaken. The inspector spent time talking with staff and service users. The focus of the inspection was to assess Northwood House in accordance to the National Minimum Standards for Younger Adults. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. Some Standards were not inspected in full. It is intended that these areas will be inspected in detail at the next inspection.Positive feedback was received from service users spoken with about standards of care within the home. What the service does well: The home provides many opportunities for service users to express themselves, they have freedom of choice and autonomy over their lives. Staff enable service users to have opportunities to maintain and develop social, emotional, communication and independent living skills. Service users take an active part in community based activities and feel part of it. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: 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. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,4,5 Service users have the information they need to ascertain whether the home can meet their needs. However some minor amendments were noted as being needed. Service users rights are protected by a written contract. Prospective service users also have the benefit of a trial period at the home. Service users can be confident that their needs will be properly assessed prior to moving to the home. EVIDENCE: The Statement of Purpose and Service Users Guide for Northwood was seen to include most of the information outlined in the Standards. The Manager was requested to ensure that it includes all information outlined in Standard 1.2 and Schedule 1.of the Care Standards Regulations. The Manager reported that a copy of the previous inspection reports are made available to service users and their families on request. A written contract / statement was available outlining service users’ rights, responsibilities, and conditions of placement is in place. Each service user has been provided with a copy. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 9 Records held showed that service users have an assessment which identifies their individual needs prior to or on admission to the home. The information is provided by the service users, their families and health / social care professionals. This is then reflected into the care plans and these are developed in agreement with the individual. The records also reflected that there may be a transitional period for new service users and ongoing assessments to meet the changing needs were evidenced within service user records. Prospective residents have the benefit of a trial period at the home to assess whether the home can or cannot meet their needs. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Individual plans are comprehensive identifying needs and personal goals and are specific to the individual service user. Care plans showed that service users are enabled to make decisions and choices. Service users are enabled to take responsible risks through a thorough risk assessment process. EVIDENCE: The home is committed to supporting the service users in accordance with their needs and goals. This was evidenced through the care plans which detailed the areas of support that the service user needed and how this support is provided by the staff. There were guidelines in respect to routines and behaviour. The deputy manager confirmed that these are reviewed with the service users on a regular basis and the families are supported to be involved. All care plans viewed had short and longer term goals which had been agreed with the individual. The care plans reflect those of the adjoining home – but these are still in the process of being fully updated. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 11 Service Users rights to make decisions are respected and the care plans reflected their ability to make an informed judgement. Care plans included in depth information concerning the preferred lifestyle and choices. Risk assessments were discussed and viewed and detailed documentation recorded how to support Service Users in their daily living activities and identified how to minimise risks for personal safety. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16 Service Users are supported in accessing appropriate activities so that they may lead fulfilling lives. Service Users are supported to maintain contact with families that ensure they continue to receive emotional support. The home promotes the rights and choices for all Service Users and provides a varied and balanced diet EVIDENCE: It was evident throughout the inspection that Service Users are able to take part in a variety of activities including attendance at the local college, support from tutors within the home to help with maths and literature, and preferred leisure activities. The inspector spoke to Service Users who confirmed the educational activities they enjoyed and the inspector was shown around individual rooms and these reflected individual choices and preferences. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 13 The home was clearly committed to enabling Service Users to access local facilities and it was confirmed by Service Users that they visit the local shops, go to the cinema and also enjoy swimming. They also go on outings to the other areas including a recent visit to the seaside. Risk assessments are in place in order for staff support Service Users in these activities. It was confirmed by the Deputy Manager that outings also take place during the evening and at the weekend. It was confirmed that Service Users are able to maintain contact with relatives and friends where they wished to do so. The daily routine promoted individual choice within the home, and Service Users privacy was respected for example no room was entered without permission from the individual. The rooms reflected personal choices and Service Users were encouraged and supported to maintain their own rooms. The care plans evidenced responsibilities and preferred tasks around the home and individual form of address. It was obvious to the inspector that the Service Users were happy in the home. Meal times are flexible to suit activities and schedules. Service Users are able to choose where they eat and also have the facility to make drinks, meals and snacks for themselves and others as part of their individual care plans. During the inspection food storage areas were inspected and a good variety of food was found including meat, vegetables and fresh fruit. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Personal support is provided in accordance with the Service Users wishes so enhancing individual lives. All health needs are addressed in agreement with the Service Users in the care plans and this ensures that their needs are met. EVIDENCE: The care plans documented the personal support required for individual Service Users and reflected their choices and preferences and staff were observed offering guidance where needed. Times of getting up / going to bed, having baths, eating meals and other activities are flexible to allow for different Service Users daily routines. All Service Users were able to make their own choice with regards to what they wished to wear and their hairstyles and this was evident by their individual appearance. All Service Users are allocated a key worker and the inspector observed excellent interaction between staff and Service Users. The care plans also fully documented all physical and emotional healthcare needs and where able Service Users filled in or were supported to fill in appropriate forms. The inspector observed within the care plans records of health care provided by G.P., chiropodist, dentist, optician. Visits to the hospital were documented and there was also evidence of other outside Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 15 services including counselling and psychology input. Service Users physical and emotional health is monitored on a daily basis through their daily records and these correspond with support assessments held in the care plans – this system ensures that all Service Users receive continuity of care and support and that potential complications and problems are recognised and dealt with at an early stage. It is evident through records that the emotional health support is of a high priority to this home and the staff are pro-active in maintaining and supporting Service Users with their emotional needs in order to maintain their quality of life. The manager reported at the time of the inspection no residents were undertaking management of their own medication. The inspector viewed the medication storage arrangements and some records including Medication Administration Record (MAR) sheets, and the protocols for the administration of “PRN/As Required” Medication. The Home uses a Monitored Dosage System and it was evident the Home had sought advice and information from the supplying pharmacist. Only authorised staff members undertake the administration of medication following training. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Service users know that their concerns and complaints are taken seriously and are protected from the risks of abuse. EVIDENCE: A copy of the Home’s complaints procedures was reviewed along with the manager. The procedure included details of how to complain, timescales for response and information for referring a complaint to the Commission for Social Care Inspection A copy of the complaints procedure has been provided and explained to service users where possible. The home’s Policy for the Protection of Service Users and staff “Whistle blowing” procedure was discussed. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Full training is provided in abuse. More courses are planned to ensure all staff receive the training required to protect service users from abuse. Criminal Record Bureau Checks (CRB) have been obtained for all staff. Any staff where their CRB has not been received by the home is supervised at all times. The Manager is aware of her obligations with regard to ensuring the safety of Service users and protecting them from abuse. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,27,30 Service users live in a clean comfortable home, which is suitable for their needs. EVIDENCE: The Inspector undertook a tour of the home including some service users rooms, with their permission, bathroom/toilet facilities and communal areas. All areas viewed appeared bright, cheerful, and airy. The home employs a handyman. It was evident that some of the rooms had been decorated since the last inspection. The manager explained that this was ongoing. The number of toilet and bathroom facilities provided by the Home meets current required standards. Toilets and bathrooms were lockable offering service users’ privacy, although staff are able to access toilets/bathrooms in an emergency if required. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 18 A domestic assistant is employed to undertake cleaning of the Home with additional cleaning undertaken by care staff and where appropriate, service users. On the day of the inspection the home appeared clean and hygienic. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 Service users’ care, social and emotional needs are promoted by the employment of caring and suitably trained staff. Service users are protected from potential abuse by the home’s robust staff recruitment procedures. EVIDENCE: The home has a mix of management personnel, care staff, maintenance specialist, and housekeeping staff. A copy of the staffing roster seen indicates that rotas have been prepared for the following month. The home provides sufficient staff to meet the needs of service users. The manager stated this was always under review to take in to account any extra activities and changing needs. The rota and observations during the inspection reflected sufficient staff to support residents to participate in activities and to meet their personal needs. The Registered Manager stated that staffing levels are regularly reviewed taking account of the changing needs of residents. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 20 The Manager and the Registered Provider have encouraged a continuing development and training programme within Northwood, which has supported staff to attain a high level of training. Training and development are linked to the homes’ service aims and to service users’ need and individual Plans. On-going training is taking place for all staff. The home has a development programmed which the Manager stated meets National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. From records viewed by the inspector all staff had received training to NTO guidelines. The manager is in the process of updating the training matrix to reflect an overall picture of staff training within Northwood. The inspector viewed details of the Home’s recruitment procedure and a number of records relating to staff members recruited. The Home undertakes a recruitment practice including submission of an application form detailing all previous work history, requests proof of I.D and copies of qualification certificates, seeks written references. All staff appointments are subject to a probation period, which is subject to review. The Manager reported all staff had received statements of terms and conditions of employment, evidence of which was seen in the file. Staff receives supervision on a regular basis, as evidence by records seen within the home. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,42 The home is run openly and efficiently, which enables the needs of the service users to be met. The home is run and managed to protect the health and safety and welfare of service users. EVIDENCE: Standard 38 was recorded as 4 – Standard exceeded. Evidence to support this was observed at this inspection. Judgment was gained from both this and the previous inspections. Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 22 The management team communicates a clear sense of direction and leadership which staff and service users understand and are able to relate to the aims and purpose of the home. The manager has strategies for enabling staff, service users and other stakeholders to voice concerns and to affect the way in which the service is delivered. The process of managing and running the home is open and transparent. The inspector viewed records relating to staff training, Health and Safety Procedures, maintenance and servicing, and risk assessments, which were discussed with the manager. The inspector viewed the Fire Log book, which was up-to-date, reflecting checks and servicing of fire safety equipment had been undertaken at the required frequency. Procedures are available for the reporting of accidents and incidents (Regulation 37) A coded door system (linked to fire alarm system) is used at the Home Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Northwood House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 4 x x x 3 x H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 24 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 1 Regulation 4(1) Requirement 4.—(1) The registered person shall compile in relation to the care home a written statement (in these Regulations referred to as “the statement of purpose”) which shall consist of— (a) a statement of the aims and objectives of the care home; (b) a statement as to the facilities and services which are to be provided by the registered person for service users; and (c) a statement as to the matters listed in Schedule 1. Timescale for action 20/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Northwood House H56-H06 S23981 Northwood House V224438 200605 Stage 4.doc Version 1.30 Page 26 - 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. 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