Inspection on 12/12/06 for Rochester House

This inspection was carried out on 12th December 2006.

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

Rochester House 23/01/06

Rochester House 25/07/05

Rochester House 31/03/05

Rochester House 14/01/05

Rochester House 28/01/04

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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 Rochester House 221 Maidstone Road Rochester Kent ME1 3BU Lead Inspector Jo Griffiths Unannounced Inspection 12th December 2006 11:30 Rochester House DS0000028968.V303832.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 Rochester House DS0000028968.V303832.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. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rochester House Address 221 Maidstone Road Rochester Kent ME1 3BU 01634 847682 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) The Regard Partnership Limited Kelly Hanson (not registered) Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: Rochester House is owned and managed by The Regard Partnership. It is currently registered to accommodate thirteen Adults with learning disabilities, but now only has accommodation for 10 people. The Manager intends to apply to CSCI to vary the registration to reflect this. There is a new Manager of the home. She is applying for registration. There are three floors, the visitors room, administration area, laundry room and sensory room are situated in the basement. Service users bedrooms are on the ground and first floor; there is a lift available to all levels. The house is situated on the outskirts of Rochester town centre and public transport is easily available. Service users receive 24-hour support. The home employs a manager, a deputy manager, 2 seniors, and 13 support workers. The base fee for this service is £1113.82 per week. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced. The deputy manager was on duty and the Manager came in to help with the inspection. Some of the people living at the home were spoken with and staff were seen supporting them with their everyday tasks. Some of the records were seen and the inspector had a look around the home. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 6 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 Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 7 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): Standards 1, 2, 3, 4 and 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are given the information they need about the home. Service users needs are fully assessed and kept under review. Service users know the home can meet their needs. Service users are given the opportunity to test drive the home. Service users have a contract for their support. EVIDENCE: The Statement of Purpose had been reviewed since the last inspection. The Service User Guide has also been reviewed and produced in picture format. The deputy Manager said that a copy of this is sent to people when they show an interest in moving to the home. It is the policy of the home that new people moving in have an opportunity to visit the home and test drive it first. There had been 2 new admissions to the home recently where this had not been taken up by the service users or their Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 8 relatives as their current home was closing immediately. The Manager visited them at their current home to do a full assessment. The Manager and staff have worked with these people to help them settle in and find their bearings in the new area. The assessments and care plans for these people have been constantly evolving since their arrival to ensure their needs are properly identified. All the staff contribute to the assessments of peoples needs. Through observation of support, discussion with people at the home and staff and through looking at care plans it was evident that the needs of all the current residents of the home are being met. Each person has a contract with The Regard Partnership for the support and service they will receive. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 9 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): Standards 6, 7, 8 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users have a plan that meets their individual needs. Service users are supported to make decisions about their lives. Service users are supported to be involved in the running of the home. Service users are supported to take risks as part leading an independent lifestyle. EVIDENCE: Each person living at the home has a care plan that outlines the support they need to lead independent and interesting lifestyles. They have been involved in developing their own plan and have signed to agree it where possible. The care plans have been reviewed regularly and all staff have been made aware of the content through supervisions and team meetings. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 10 There is a clear ethos in the home that the people living there should be encouraged to make decisions for themselves as far as they can. There are weekly meetings that they attend to discuss things such as the menu and any activities they would like to do. On the day of the inspection some of the people living at the home were coming and going from various activities as they wished to. The staff were seen to support people to make choices and were seen to respect these choices. The residents of the home are encouraged to be involved in cooking, where they can. There is a small kitchen on the 1st floor that is being developed for use by service users. Two service users have been booked to do some food hygiene training so that they can independently use the facilities. The Manager is working to develop more communication tools in the home. There are already picture cards in use to help people decide what meals they would like, activities they would like to do or to express how they are feeling. The complaints and abuse policies have been translated into pictures and the Manager hopes to continue this in more areas. Risk assessments have been completed for activities that people like doing. Some people are able to go out independently and this has been assessed to ensure they are safely supported to continue to do this. This is very important for people to feel they are in control of their lives. The staff in this home have a clear commitment to this. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 11 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): Standards 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users have opportunities for personal development. Service users are supported to take part in the activities they choose. Service users are supported to be part of their local community. Service users are supported to enjoy leisure activities of their choice. Service users are supported to have friendships and relationships. Service users rights are recognised and they are aware of their responsibilities. Service users enjoy a balanced diet. EVIDENCE: Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 12 There is a range of activities available for people to choose from each day. These include activities at home, such as massage, arts, music or using the home computer, as well as activities within the local community such as shopping, lunch out, bowling or swimming. People living at the home are supported to say what they would like to do and are then supported to arrange it. One person has been supported to get a job and will be starting in the New Year. Training sessions have been offered to people in areas they are interested in, as mentioned above a food hygiene course has been booked for two people. Records show that people have busy and interesting lives. One service user said “ I like to be able to do the things I want to”. Another said “ I can’t wait to go and stay with my mum for Christmas”. There is a large TV in the main lounge and people can have their own TV, stereos etc in their bedrooms. There is a sensory room on the lower floor that can be used by people to relax or for massage. People living at the home are supported to maintain contact with their family and friends and can invite them to the home when they want to. They are also supported to build new friendships and relationships if they choose to. Support and guidance in expressing sexuality and having relationships is available for service users. The rights of the people living in the home are respected by staff. This includes the right to privacy, to have relationships and to make their own decisions. The responsibilities that residents of the home have are outlined in the Service User Guide and contract. The weekly menu is chosen by the people living at Rochester House. Picture cards are available to help them to do this. Staff offer guidance to help people make healthy choices. The people spoken with said they liked the food. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 13 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): Standards 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users personal care needs are met in the way they prefer. Service users health needs are met. Service users are supported to manage their medication safely. EVIDENCE: Each person has their personal and health care needs set out in their individual plan. The records show that support is given following these plans. Evidence was seen that the staff respect the privacy of the people living at the home. Each person is registered with a GP and has support from other healthcare professionals where they need to. Where staff are required to use a hoist with one person they have received training to do this. Service users are consulted on the support they wish to receive and how they would like this to be provided. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 14 All the people that live at the home have their medication held in the central medicines cupboard and staff are responsible for the storage and administration of these. If they wanted to service users could hold their medication, but no one has chosen to do this at present. All the staff have completed training in medication with an accredited provider. It is recommended that the Manager follows this training up with an assessment of each persons competence to administer medicines. This could be done as part of their supervision sessions. All the medication was stored safely and records were completed accurately. Further in depth training is planned for all senior staff to begin in February 2007. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 15 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): Standards 22 and 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users know how to make a complaint and know their concerns will be taken seriously. Service users are protected from abuse. EVIDENCE: The complaints procedure is available to people in picture format to make it easier for everyone to use. There have been no recent complaints received, but it was evident from previous entries that any complaints are taken seriously. The Manager said that, because the weekly meetings allow service users to say how they are feeling about things, any concerns are usually dealt with before they reach the complaint stage. Those spoken to said they knew who to speak to if they had any concerns. The abuse policy for the home has also been produced in picture format and staff have made sure that people understand their right to be protected from abuse within the home. As well as the weekly meetings in the house each person has a regular meeting with their keyworker where they can talk on a 1:1 basis about any personal issues. The staff said the Manager is very open and approachable and the service users were seen to be comfortable in sharing their views and requests with her on the day of the inspection. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 16 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): Standards 24, 27, 28, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a homely, comfortable and safe environment. Service users have access to sufficient suitable bathroom facilities. Service users have use of sufficient shared space. Service users benefit from a clean home. EVIDENCE: The home was welcoming and homely. The Manager said that most areas of the home had been newly decorated and new carpets fitted in bedrooms. One person was being supported to move to a new bedroom on the ground floor as it was felt this would better meet her needs. All service users have a single bedroom. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 17 There is a large lounge on the ground floor with a dining space and a smaller lounge/kitchen on the 1st floor. The main kitchen is also accessible to the people living at the home. Sufficient bathroom facilities are available for people to use and the deputy Manager said some of these were going to be refurbished next year. On the basement floor there is an activity room, a fully equipped sensory room and a visitors room for use by people living at the home. There is a large rear garden and a vehicle for use by service users. All areas of the home were well maintained. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 18 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): Standards 32, 34 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported by qualified staff. Service users are protected by the homes recruitment procedures. Service users are supported by trained staff. EVIDENCE: All staff have received the training they need to support people in the home effectively. Where updates are needed these have been booked. The Manager assesses the training needs of the staff based on the needs of the service users. For example, training in epilepsy and moving and handling had been provided as this reflected the needs of a new person moving to the home. Over 50 of the staff team have either achieved their NVQ award or are working to achieve this. The recruitment files of a sample of the employees were reviewed. The appropriate employment checks had been made and safe procedures followed. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 19 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): Standards 37, 38, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home. Service users benefit from a qualified Manager. Service users are asked their views of the service. Service users health and welfare are protected. EVIDENCE: The new Manager has been in post since February 2006. Within the last year the home has improved considerably and it is evident that the Manager has strong leadership of the home. The staff and people living at the home said the Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 20 Manager is easy to talk to and has made things much better in the home. A relative visiting the home also said that the home had greatly improved under the new Manager. The Manager is applying for registration with CSCI. She is working toward completion of the NVQ 4 in care and the Registered Managers Award. The Regard Partnership send out annual questionnaires to their service users and relatives to gather their views on the quality of the service they are receiving. In addition, within the home there are regular opportunities for people to say what they think about the home. The Manager reviews all records, incidents forms and audits various aspects of the home on a weekly basis. There are no issues of health and safety concern within the home. All the relevant servicing of equipment and safety systems has been completed and risk assessments are in place for the general environment. A weekly health and safety audit of the home is carried out. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 21 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 4 2 4 3 4 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 3 28 4 29 x 30 3 STAFFING Standard No Score 31 x 32 4 33 x 34 3 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 x LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 x 4 3 4 x x 4 x Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 22 N/A 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. 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. 1 Refer to Standard YA20 Good Practice Recommendations It is recommended that the Manager devise a system for testing the competence of staff to give medication. Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Rochester House DS0000028968.V303832.R01.S.doc Version 5.2 Page 24 - 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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