Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: Peacehaven 43a Maldon Road Tiptree Colchester Essex CO5 0TS The quality rating for this care home is: 1 Star adequate 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: Neal Cranmer Date: 1 3 0 1 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. They reflect the things that people have said are important to them: 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: ï· Put the people who use social care first ï· Improve services and stamp out bad practice ï· Be an expert voice on social care ï· Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. 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. Internet address www.cqc.org.uk Information about the care home
Name of care home: Address: Peacehaven 43a Maldon Road Tiptree Colchester Essex CO5 0TS 01621818220 F/P01621818220 patricia.payne2@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Patricia Anne Payne Name of registered manager (if applicable) Mrs Patricia Anne Payne Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 1 0 0 care home 3 learning disability physical disability Additional conditions: Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 3 persons) One person, under the age of 65 years, who requires care by reason of a learning disability, who also has a physical disability, and who has resided in the home since April 2002 The total number of service users accommodated must not exceed 3 persons Date of last inspection 2 2 0 1 2 0 0 8 A bit about the care home Peacehaven is a family sized, semidetached, chalet style property. The house is close to the centre of Tiptree. Peacehaven is the home of the provider/manager as well as to the three people cared for. The furnishing and routine of the home is family orientated and people living at the home consider themselves to be part of a family. There is a small garden to the rear of the property and parking to the front. Fees currently charged at Peacehaven are £457.17per week, and no additional charges are made. 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: 1 Star adequate 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 How we did our inspection: This is what the inspector did when they were at the care home This inspection visit took place on the 13th of January 2008 without people knowing it was going to happen (unannounced). During the inspection visit we spoke with people who live in the home, the registered manager and their deputy. In addition to the above discussions we looked at a range of documentary evidence provided both prior to the visit and during it, these documents included the homes AQAA (Annual Quality Assurance Assessment, this is a document that the home completes to tell us what they do well), peoples care plans, and the homes policies and procedures. What the care home does well People living at Peacehaven say it is their home, and they enjoy being part of a family unit, where live is relaxed. People living in the home are encouraged to make choices, about things like when they get up in the morning and go to bed at night, what they do during the day, and what they have to eat. People living in the home have pets, and take an active part in the care of their pets. What has got better from the last inspection What the care home could do better The homes Statement of Purpose requires amendments to remove typing errors. It would also benefit from being provided in a pictorial format, to make it more accessible to those people who are less able. Care plans continue to require further development to ensure that they reflect peoples wishes. The home needs to review the range of community based activities it offers, to ensure that people were provided with opportunities to lead fulfilling and rewarding lives. The home needs to further develop its process of quality assurance to ensure that the views of people are listened to and addressed. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Neal Cranmer CPC1 Capital Business Park Fulbourn Cambridge CB21 5XE 01223 771350 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 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. Prospective service users can expect to be provided with the necessary information they require to make an informed choice about the homes ability to meet their needs. Evidence: The people living in the home have been there for a number of years. There have been no new admissions made to the home since the last key inspection. It was therefore, not possible to assess the current admission process in practice. However the home did have an assessment process for assessing newly referred people, the process included visiting the prospective person in their own home, and arranging opportunities for the person and their relatives to visit the home. The service had produced a Statement of Purpose. This is a document required by legislation that outlines the services provided by the home. The Statement of Purpose was last reviewed in January 2008, and included details of the range of needs provided for, the staffing levels and qualifications of staff, reference to the homes complaints policy, and the policy for admitting new people to the home. It was noted that the document contained a number of typing errors, and it would benefit from being developed pictorially to enable less able people to make use of it. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People living in the home are consulted with regarding day-to-day decisions within the home. Evidence: All of the people living in the home had a care plan. All of the care plans provided good information about the things that people were able to do for themselves as well as the things that they required assistance with. This is important because it helps to enable people to maintain their independence. There was evidence that the care plans were being kept under review on a six monthly basis. This is important to ensure that the care plans are reflective of peoples current needs. Evidence was seen during the inspection of people being consulted with about day-to-day decisions, such as what they wanted for lunch and how they wanted to spend their day. Observation of these interactions suggested that staff regularly consulted with people in this way. All of the care plans contained evidence of risk assessments having been undertaken regarding manual handling. This is important to minimize any risk to either the people living in the home or the staff supporting them. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People who live at the home have limited opportunities for participating in interesting community based activities. Evidence: Daily records were kept for each person living in the home. These summarized how the person had spent their day. The daily records for all three people were looked at during the inspection. The record for the first person indicated that they attended a resource centre Monday to Friday from 9-4, on the day of the inspection this person had already left to attend the centre at the time of our arrival, the record also said that during the evening this person chose to spend their time relaxing, and watching television and videos, the record also said that the person enjoyed reading and outings. The activity programme for the second person indicated that they enjoyed looking after the homes pets, relaxing watching television and listening to music. The third person’s activity plan was a little more varied and included going shopping, playing games, and going out for lunch. Whilst it is recognised that time spent in the home, watching television, relaxing and listening to music maybe an important part of a persons week, it does not if it is the only activity on offer describe a valued and fulfilling way to spend someones time. Evidence: Discussion with service users indicated that they were able to speak to their relatives at any time they wanted to. The registered manager stated that the home has an open door policy on the receiving of visitors and guests are always offered drinks and a meal, they went onto say that the home has generally good family contact, and one person is supported by the home to visit their relative on a monthly basis. At the time of our arrival one person had already left the home, one was still in bed, and the third was about to have their breakfast, people therefore were seen to have their meals at different times. The atmosphere was relaxed, and people were consulted with about what they would like. The home maintained records of meals that people had eaten, and one person spoken with said how much they enjoyed the meals provided. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People living in the home can expect their healthcare needs to be identified and well met. They can further expect to be protected by the homes policy and practice regarding the administration of medicines. Evidence: All of the people living in the home are registered with a local General Practitioner, and are further supported by district nurses and social workers, for all other healthcare support the home accesses generic services for example: opticians, dentists and chiropodists. Healthcare records sampled were well documented and included details of the appointment as well as any outcome. This is important to ensure that there is a clear record relating to the persons medical history. At the time of our visit none of the people living in the home were self medicating, records relating to the administration of medicines were all in order with no evidence of any gaps or omissions. Medication is kept stored in a locked cabinet in the lounge. All staff administering medication had received training in the administration of medicines from the dispensing chemist. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People who live in the home can expect staff to listen to to their concerns, but cannot be confident that staff will have sufficient understanding of wider safeguarding issues. Evidence: There have been no complaints received by the Commission or the home since the last inspection. It was evident from the visit to the home that there was a good level of communication and understanding between people who live at Peacehaven and the staff who care for them. Requests were seen to be addressed promptly and it was clear that people felt cared for and part of a supportive family environment. Evidence was presented that showed that all staff had received training in safeguarding in June 2008; however discussion with the registered manager regarding safeguarding issues did not fully support this claim. This was evidenced by the viewing of a letter on a service user’s file in which the person had made a financial bequest to the manager and her family. It is unusual for individuals working in care homes to accept financial bequests, and it was not apparent whether any independent advocacy had been involved in supporting the person in making this decision. It is important that the home fully consider these issues to ensure that any allegations of abuse could be fully responded to. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People who live in the home can expect to be encouraged to use it as their own home and be consulted with about the decoration of their bedrooms. Evidence: During a tour of the premises all of the bedrooms were visited, and were pleasantly decorated and furnished. One of the people spoken with said that they had chosen the colours for their room. The homes downstairs bathroom is in need of redecoration, and some aspects required upgrading. The homes laundry facility is situated outside of the building in a garden shed, and was equipped with a domestic style washing machine and tumble dryer, none of the people living in the home were involved in managing their own laundry. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People who live in the home can expect to be protected by the homes recruitment practice, and can expect to be supported by a staff team who are well trained. Evidence: The home employs five care staff; training records sampled showed that two of these staff held a N.V.Q (National Vocational Qualification) at level 2 or above. In addition the training records sampled for all of the staff employed in the home showed that since the last inspection undertaken in January 2008 all of the staff have received training in: food hygiene, health and safety and fire awareness, infection control, first aid, safeguarding and manual handling. The homes recruitment practice was reviewed by the viewing of all staff files, all of which contained all of the necessary documentary evidence to ensure a robust recruitment process including: criminal records bureau checks and references. Discussion with the manager and the deputy indicated that they understood the importance of having a robust recruitment process. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. The health and safety of people who live in the home is protected by the actions of the manager. Evidence: The registered manager has not completed the Registered Managers Award, although they do have many years experience of working in and managing care homes. The registered manager and their deputy manager work together closely and run the service in a very homely way. The registered manager reported that they have started to develop a process for reviewing the quality of the homes service provision. This included the use of surveys being sent out to people living in the home, friends and relatives, staff and healthcare professionals involved in the home. At the time of the visit none of these surveys were available for viewing. Although no evidence was readily available to assess how people are consulted with on aspects of the running of the home, observation throughout the course of the visit showed that staff were always asking the people who lived in the home what their views were. A range of safety certificates were sampled to assess the homes safe working practices, all of the safety certificates sampled were current and in order. Are there any outstanding requirements from the last inspection? Yes ï No ï£ 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 1. 12 15 The home must ensure that care plans reflect the aspirations of people so that they can lead fulfilling lives. The previous timescale set of the 31/10/2007 was not met. 31/08/2009 2 39 24 The home must implement a 31/08/2009 quality assurance process that ensures the service is developed in the way people living in the home want. The previous timescale set of the 30/04/2008 was not met. 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 Description 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 Description Timescale for action 1 12 15 The home must ensure that peoples care plans reflect their aspirations. To ensure that people can lead fulfilling lives. This is now a repeat requirement. 31/08/2009 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 1 23 The home should ensure that where people living in the home make decisions about their finances that affect people working at the home, that there is independent support made available to the person. 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.
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