Inspection on 14/03/07 for Penshurst

This inspection was carried out on 14th March 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Penshurst 26/08/08

Penshurst 17/11/05

Penshurst 30/11/04

Penshurst 27/07/04

Penshurst 16/03/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 Penshurst 24 Spring Hill Ventnor Isle Of Wight PO38 1LF Lead Inspector Mark Sims Unannounced Inspection 14th March 2007 10:00 Penshurst DS0000012584.V328403.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 Penshurst DS0000012584.V328403.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. Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Penshurst Address 24 Spring Hill Ventnor Isle Of Wight PO38 1LF 01983 853184 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) Mrs Eveline Anne Basile Mrs Eveline Anne Basile Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th November 2005 Brief Description of the Service: Penshurst is a home providing care and accommodation for three adults with a learning disability. The home is owned and managed by Mrs Basile. It is a large three storey Victorian residence located in a central part of Ventnor town, close to its shops and amenities. While there is no off road parking, the large town centre car park is very close by and on road parking outside the home is sometimes available. Service users’ accommodation is on the first and second floors, and would, in a general sense, be unsuitable for individuals with mobility difficulties as there is no passenger or stair lift. There is an attractive and reasonably sized rear garden, which is available for use by residents. Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first ‘Key Inspection’ for Penshurst, a ‘Key Inspection’ being part of the new inspection programme, which measures the service against the core and/or key National Minimum Standards. The fieldwork visit, the actual visit to the site of the home, was conducted over one day, where in addition to any paperwork that required reviewing the inspector met with service users and undertook a tour of the premises to gauge its fitness for purpose. The inspection process also involved pre fieldwork visit activity, with the inspector gathering information from a variety of professional sources, the Commission’s database, pre-inspection information provided by the service and linking with previous inspectors who have visited the home. What the service does well: What has improved since the last inspection? What they could do better: The following is an indication of the areas where the service could perform better: • The Inspector found nothing that would improve the outcomes for the service users residing at Penshurst. Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Penshurst DS0000012584.V328403.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 Penshurst DS0000012584.V328403.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 2: Prospective service users and/or their representatives have the information needed to choose a home, which will meet their needs. They have their needs assessed and a contract which clearly tells them about the service the will receive. EVIDENCE: Pre-admission Assessment: The evidence indicates that the residents living at the Penshurst are satisfied with the overall service provided to them, which suggests, that their assessed needs and aspirations are being meet. • In discussion with the managing/proprietor it was established that on one has been admitted to the home since 2001 and that the managing/proprietor intends not to admit any new service users should anything occur within the current resident group. As no one new has been admitted to the home it is impossible to say with any certainty how useful or effective the home’s pre-admission procedures would be, however, given the levels of satisfaction demonstrated by the present resident’s group and the positive feedback from four health & social care professionals and a local general DS0000012584.V328403.R01.S.doc Version 5.2 Page 9 • Penshurst practitioner, the inspector is confident that the process is reasonably robust and thorough and clearly identifies the needs and aspirations of the service users. • These findings mirroring those of the previous inspector who found at the last inspection: ‘the home supports all three residents to lead independent lifestyles according to their needs and wishes. The inspector was able to meet with two of the residents who confirmed that for them life in the home was very positive’. ‘The home does not offer short-term intermediate care and the proprietor has confirmed that no new residents are likely to be admitted in the future’. Penshurst DS0000012584.V328403.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 6, 7 and 9: Individuals are involved in decision-making about their lives, and play an active role in planning the care and support they receive. EVIDENCE: Care planning: The evidence indicates that the service users are central to the home’s care planning process/programme; and that the managing/proprietor knows and understands the needs and abilities of the people living with her. • All three care planning records were reviewed during the fieldwork visit and found to contain useful and important information about the service user, which reflected their involvement with health and social care professionals, issues effecting their general wellbeing and leisure activities & outings. Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 11 Whilst the care planning documents in use, may not fit neatly into the pigeon whole of being a traditional care plan, they are functional documents that provide a good insight into the lifestyles of the people residing at Penshurst. Traditional care planning models would be of little benefit to the service or the service users, as apart from the managing/proprietor and her immediate family, who sometimes support her in the day-to-day operation of the home, Penshurst employs no staff that require direction via a plan of care. • Four professionals, two health and two social care, who responded to our survey indicated that generally they are satisfied with the home’s approach to meeting people’s care needs, the two health care professionals ticking ‘always’ in response to the question: ‘are individuals health care needs met by the service’, whilst the social care professionals ticked ‘usually’ in response to their question: ‘do the care service’s assessment arrangements ensure that accurate information is gathered and that the right service is planned and given to the individuals’. One person adding: ‘an excellent small homely environment, which is providing a good level of care & support. Very individual care plans appropriate to clients needs’. • In conversation with the clients at Penshurst it was evident that they appreciate the efforts made by the managing/proprietor in meeting their health and social care needs and that they would not or could not consider living anywhere other than at their current address. They discussed the support they receive when accessing health care, in undertaking personal care, in socialising, exercising their rights to independence, meals & snacks and the efforts made to ensure the environment was suitable and well maintained. Independence and decision-making: The evidence indicates that the service users are fully able and empowered to make decisions for themselves and live as individuals within a group setting. • On arriving at the home it quickly became clear that the service users were used to leading active and for them fulfilling lives, the inspector asked how long he was going to be present in the home as they were hoping to go out for the afternoon. Throughout the inspector’s time at the home the service users were observed to be involved in a number of differing activities, ranging from watching the TV to undertaking some gardening. • Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 12 The service user in the garden, discussing how he often spends time tending to pots and helping the managing/proprietor with the general maintenance of the garden. • The care records, referred to above, also provide clear evidence of the service users exercising their rights to independence and selfdetermination, one service user’s records documenting how he goes into the town to purchase and/or pick up magazines and confectionaries. The documented evidence supported by the service user himself, who during a conversation, discussed going in to town to collect his magazines and the good relationship he has built up with the owner of the shop he visits. • It is also clear, from the last inspection report, that similar findings had been made the previous inspector documenting: ‘It was clear from speaking with residents that they have individual choices about the activities in their lives and can manage their own finances if they wish. Each has different lifestyle preferences from taking life easy and relaxing in the home, to tending the garden, and spending time at day services and venues in the local town. They confirmed that there was no shortage of trips out to cafes and places of interest with the proprietor, especially during fine weather’. Further evidence of how well the service meets the needs of the clients, with regards to self-determination, autonomy and decisionmaking was provided by the health and social care professionals, all four survey responses containing phrases such as: ‘individualised care’, ‘promotes choice and independence’. All four professionals also ticked ‘always’ in response to the specific question: ‘does the care service support individuals to live the life they choose’. Supported Risk Taking: The evidence indicates that risks are taken by the service users, as part of their independence, however, this is part of a risk based assessment undertaken by the managing/proprietor. • It is clear from the information above that service users are encouraged to participate in activities, which contain some risks, independent shopping, etc. However, the potential for any harm to come to the person is limited via the home’s risk management process, which includes documenting the potential risks and how these can best be meet by the service, as seen on the individuals care records. Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 13 • • The above information was also noted at the last inspection, the previous report indicating: ‘the inspector noted risk assessments with the care records, which mainly focused on health and safety issues’. A pre-inspection questionnaire, which is provided to all services in the build up to a fieldwork visit, also indicates that risk assessments and a risk assessment process is in operation at the home. • Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Standard 12, 13, 15, 16 and 17: The people using this service are able to make choices about their lifestyle, and are supported to develop life skills, via social, educational, cultural and recreational activities. EVIDENCE: Activities: The evidence indicates that service users are able to take part in activities that meet their needs. • The service user plans provide evidence of the active life enjoyed by the resident’s of Penshurst, including numerous shopping trips, visits to garden centres, general outings/trips and holidays. The fieldwork visit also had to be re-arranged, as on arriving at the home to undertake the first unannounced visit, the inspector was greet with the news that everyone was on their way out, a similar situation almost DS0000012584.V328403.R01.S.doc Version 5.2 Page 15 • Penshurst occurring on the second fieldwork visit, when the service users enquired as to the length of time the inspector would be present in the home, as they were hoping to go out in the afternoon. • The pre-inspection questionnaire (PIQ), provided to services prior to undertaking fieldwork visits, also mentions the outings undertaken and a recent holiday in Fishbourne, which was arranged whilst the new boiler was installed at the home. In discussion with the service users it was clear that they to find life at the home fulfilling and that the various activities undertaken meet with their needs, people discussing New Years parties, trips to two particular café that they like and popping into town for personal items. As already identified the professional feel the home promotes independence and choice and this was further supported by the manager’s reference to meetings with the resident’s to discuss this years holiday, the service users showing a preference for a holiday camp style break during discussions. • • Community Involvement: The evidence indicates that the service users are active members of the wider social community. • It has already been mentioned within this report that one service user in particular, visits the town on a regular basis and has built a good rapport with the owner of one of the local shops. The numerous trips out into the community to visits pubs, cafes, garden centre and shops all encourage and promote community socialisation. The PIQ lists involvement with hairdressers and chiropodist locally, whilst all three service users are registered with a local GP, who comments that the home is diligent and provides loving care, which would fit with the descriptions of a homely and family like setting, as described by several health and social care professionals. • • Relationships: The evidence indicates that the service users maintain contacts appropriate to their needs and wishes. • The evidence from the inspection, PIQ, records within the home, discussions with the manager, all indicate that the resident’s have very little family contact and/or very little family. However, the indications from the health and social care professionals is that the potential void left by this lack of relative contact, etc is filled adequately by the relationships that exist between the resident’s, the manager and her family, this best summed up by a social care professional who remarked: Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 16 ‘The clients are treated and respected like family members and it is essential for their emotional wellbeing to be together, as this is the family they have had for a great many years’. • Observations from the day of the visit provided further evidence of the close bonds that exist between the resident’s, two people who share accommodation discussing how when one of them was admitted to hospital, the other always went to visit, to keep their spirits up. Respect and Responsibilities: The evidence indicates that the service users are treated with respect and that they are not expected to take on additional responsibilities but can participate in household activities if they wish. • As mentioned one of the service users was involved in the gardening on the inspectors arrival at the home, which he discussed in terms of helping the managing/proprietor. In conversation with the managing/proprietor it was clear that on occasions people assist with washing up and clearing tables, although this is optional, one of the service users joking with the managing/proprietor about how he avoids undertaking such tasks. On speaking with the service users themselves it became clear that they do not, mind helping out after meals, etc and that daily they make their beds and keep their rooms reasonably neat and tidy. Also mentioned on several occasions within the report is the reference of the professional visitors to the home of the family atmosphere, which also indicates a shared responsibility for the home environment and co-operation and support for each other in completing some domestic chores, although again the service users joked about the managing/proprietor doing all the cooking and washing. • • • Meals: The evidence indicates that the service users enjoy and appreciate the meals provided at the home, which are flexible and adapted on a daily basis to meet people’s choices and wishes. • During the fieldwork visit the inspector witnessed lunch being provided for the service users, the lunches where well proportioned and presented and consisted of sandwiches, crisp, biscuits, tea or coffee and fresh fruit. In discussion with the resident’s they described how this was a normal lunch for them and that they ate their main meal at night, which on this occasion was to be fish, which had been decided upon as a compromise, when people voiced different opinions on what to have for tea. • Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 17 • Records maintained by the managing/proprietor, establish that a wide variety of meals are provided for the service users and that on occasions, rather than eat at home, the household go out to eat, this evidence coming from the service user plans. At previous inspection visits the arrangements for providing meals, etc has always been considered appropriate and satisfactory, the last inspector reporting: ‘The home has no set menus but aims to provide residents with what they want to eat on a daily basis. The inspector looked at records of food provided, which showed meals to be well-balanced and nutritious with fresh fruit and vegetables available. Residents can have a cooked breakfast and at least one other meal is hot. Both residents spoken with confirmed that the high standard of food continued to be maintained. Generally all three eat together in the home’s dining area, or occasionally in their lounge. Mealtimes were seen to be flexible according to their individual preferences’. • Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 18, 19 and 20: The health and personal care that people receive is based on their individual needs and the principles of respect, dignity and privacy. EVIDENCE: Personal Care: The evidence indicates that personal care is delivered in accordance with the wishes of the service users and meets their needs. • • Care plans are informative documents, which reflect the care and general service provided to the residents. During discussions people clearly understood that the managing/proprietor kept records of the daily care delivered, etc, although were not interested in the content or detail of the information contained within the reports. The care professionals were also satisfied with the content of the care plans, indicating that changes to care they recommend are included in the care DS0000012584.V328403.R01.S.doc Version 5.2 Page 19 • Penshurst plans and that the service clearly meets the needs of the people accommodated. Health Care: The evidence indicates that the health care needs of the service users are appropriately addressed and managed. • The professional comment cards indicate that the service is well respected and considered to provided service users with access to appropriate health care: A GP remarking: ‘Spotless home, diligent loving care’, as well as ticking ‘always’, to questions such as: ‘do staff (manager) demonstrate a clear understanding of the care needs of the service users’ & ‘are you satisfied with the overall care provided to service users within the home’. These comments were mirror by both the health and social care staff who also indicated that they were satisfied with the overall service provided, plus people adding comments such as: ‘identified problems early and seeks appropriate advice’ and ‘any additional support needed is sought appropriately’. • The service users themselves, as mentioned earlier in the report indicated that they have accessed health care services over the past twelve months, etc and that they are supported in visiting each other whilst in hospital. The home’s records document when people access health care resources, one person recently accompanied to the local clinic for ear syringing. The PIQ contains full details of the health and social care professionals visited by each service user, which indicates that they are well supported. • • Medications: The evidence indicates that people are well supported with their medication requirements. • The last inspector reported: ‘two of the three residents take medication. The proprietor said that she herself administers the medication according to their assessed needs and that respective care managers were in full agreement. At the time of the inspection all medication was held under secure conditions and appropriate records maintained’. The PIQ indicates that medication guidelines are available, with the records maintained indicating that medicines are appropriately administered. • Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 20 • The four health and social care comment cards and the GP comment card raise no concerns with the managing/proprietors arrangements for supporting people with their medications, the GP establishing that any changes to medication regimes, etc, are included within the records of the residents. Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 22 and 23: People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. EVIDENCE: Complaints: The evidence indicates that service users are able to raise concerns with the managing/proprietor. • • The PIQ establishes that a complaints process is available and that no complaints have been logged over the last twelve months. In conversation with the service users it was clear that they are happy to speak with the managing/proprietor over any issue that upsets or concerns them, with a definite expectation that she will address the problem and resolve it appropriately. All four professional comment cards and the GP comment card indicate that they have never received any concerns about the service or have any worries that the manager would not handle or address the issues raised appropriately. • Safeguarding Adult: The evidence again indicates that the service users are protected from abuses or harm. Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 22 • The Commission’s database’s evidence that no adult protection referral have been made over the last twelve months, a comment supported by evidence contained within the PIQ. The professional comment cards, also raise no concerns and as identified praise the home for being a family type unit, which provides satisfactory levels of care and support. The PIQ also provides evidence that the managing/proprietor has an adult protection strategy. The service users raised no concerns and went to great lengths to impress upon the inspector how much they appreciated and enjoyed living at the home. • • • Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 23 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 24 & 30: The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: Environment: The evidence is that the home is well maintained throughout. • Issues with regards to the design or layout of the home and its suitability for the long-term use of a client with increasing mobility issues has been identified at previous inspections, as well as mentioned by professionals involved with the service in the past. However, it was clear from the comments of the professionals using the comment card system and from discussions with the managing/proprietor during the inspection, that these issues are being Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 24 addressed and that alterations to the layout of the home were being planned to overcome the environmental barriers. • The PIQ also set out that the home had recently had a new boiler installed, as mentioned earlier within the report, as a consequence of the installation was an additional break from the home to stay in Fishbourne, a town on the Isle of Wight. During the fieldwork visit the inspector toured the home with the manager and was informed that decoration work, commenced on the kitchen was due to be completed shortly, it was then the managers intention to have other areas of the home redecorated, although the standard of décor throughout the home was of superb quality. The service users in discussion with the inspector indicated how much they enjoyed living at the home and that they liked the accommodation they currently occupied, although the two people effected by the room changes, etc were also looking forward to moving to their ground floor bedroom. • • Cleanliness: The evidence indicates that the home is clean and tidy throughout. • As established earlier in the report the service users are encouraged to participate in keeping their bedrooms tidy and to help with domestic chores, as they wish. At the last inspection it was reported: ‘the home was seen to be very clean, hygienic and free from unpleasant odours. Laundry is carried out in a utility room off the kitchen. It presents as a typical domestic setting, which in the circumstances is perfectly adequate for the needs of the residents. There are domestic appliances, which according to the proprietor wash clothing at appropriate temperatures. The home has in place a risk assessment record that covers a number of hazards including the safe storage of cleaning materials’. • The tour of the premise established that the home was clean and tidy throughout, an observation shared by the local GP, who stated within his comment card that the home was ‘spotless’. • Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 25 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 good. This judgement has been made using available evidence including a visit to this service. Standards 32, 34 and 35: Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. EVIDENCE: Recruitment, staff deployment and training: The evidence indicates that the needs of the service users and their welfare and safety are being appropriately addressed. • At previous inspections it has been identified that: ‘there are no staff at Penshurst. With only three independent and self-caring residents the proprietor provides round the clock support, with backup from her son/daughter in emergency situations and absences’. At this inspection it was ascertained that no changes have been made to the staffing situation at the home, although it was established that all parties involved in supporting the clients, be that in emergency • Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 26 situations, etc, have been appropriately checked against the ‘Criminal Records Bureau and Protection Of Vulnerable Adults registers. Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 27 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 37, 39 and 42: The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: Management: The evidence indicates that the home is well run and managed. • The professional comment cards indicate that the home is well managed, people remarking: ‘the manager responds promptly to meet residents health needs’, ‘Lin Basile is always very prompt when dealing with any health issues, always very quick to report any changes’, an excellent small home environment, which is providing good levels of care and support’ and ‘pro-active approach with genuine care’. DS0000012584.V328403.R01.S.doc Version 5.2 Page 28 Penshurst • The service users raised no concerns with regards to the management of the home and lead fulfilling and enjoyable lives, where the care and support provided clearly mirrors their aspirations and wishes. It has been established at previous inspection that the manager does not wish to undertake the Registered Managers Award or National Vocational Qualification in care at level 4. ‘Penshurst is a small home that does not employ additional staff. The manager Mrs Basile undertakes all tasks and has many years experience of providing a service for the current user group. She has declared her intention not to undertake management training and not to admit any new residents to the home’. However, given how well run the home is and the positive outcome for the current service users, whom the managing/proprietor does not intend to replace, when they no longer reside at Penshurst, it seems unnecessary for her to undertake the above training, provided she keeps abreast of current good practice and updates her mandatory skills as required. • Quality audit and Service User Involvement: The evidence clearly establishes that the service users are central to all activities on-going at the home. • Within the report the inspector has already referred to people being consulted with over simple issues such as the meal option for the day and larger issues such as holiday destinations and outing venues. Professional comment cards refer to choice, independence and selfdirection, all central elements to the delivery of a quality service. The service users spoken to discussed how the managing/proprietor, involved them in decision-making and kept them advised of developments, i.e. progress with the new bedroom plans, etc. The last inspector to visit the home however, did comment: ‘It was visibly clear that Mrs Basile monitors the quality of the service as environmental improvements continue to be made year on year. Additionally, there was evidence of a significant improvement in the health of one of the residents due in no small part to the proprietor’s monitoring and prompt referral to the appropriate healthcare professionals. • • • Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 29 However, there was no recorded evidence of service user satisfaction surveys or other demonstration of this standard being met. This latter comment, would appear to be at odds with the service visited this year as the additional information gathered; and reflected above, clearly establishes that quality is central to the service delivered; and that whilst documentation may not be present at this small home, it is not required to evidence the lengths the manager goes to when ensuring the needs of the resident’s is adequately meet. Health and safety: The evidence indicates that the health and safety of the service users is being appropriately managed. • • • • No immediate health and safety concerns were identified with regards to the fabric of the premises during the tour of the premises. The dataset establishes that health and safety guidance documents are available. The issue of the electrical certificate, identified at the last inspection has been addressed according to the PIQ (pre-inspection questionnaire). Contracts and certificates were note to be in place for all installations, including the new boiler, and checks on fire equipment and alarms regularly undertaken. Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 30 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 31 Are there any outstanding requirements from the last inspection? Yes 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Penshurst DS0000012584.V328403.R01.S.doc Version 5.2 Page 33 - 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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