Inspection on 16/08/06 for Seaview

This inspection was carried out on 16th August 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Seaview 24/07/07

Seaview 09/01/06

Seaview 01/08/05

Seaview 08/02/05

Seaview 21/09/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Seaview 23 Old Dover Road Capel-le-ferne Folkestone Kent CT18 7HW Lead Inspector Lois Tozer Unannounced Inspection 16th August 2006 10:30 Seaview DS0000023589.V308282.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 Seaview DS0000023589.V308282.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. Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Seaview Address 23 Old Dover Road Capel-le-ferne Folkestone Kent CT18 7HW 01303 246404 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 Robinia Care Group Ltd Mrs Yvette Hanlon Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2006 Brief Description of the Service: Seaview is part of the larger Company of Robinia Care, who specialise in care of people with Learning Disability. Seaview is a group home for eight people providing care and support to people with learning disabilities and/or mental health problems with mild to moderate behaviour that challenges. Seaview is a large detached house with a garden at the rear of the property. All rooms are of single accommodation and there are two en suite bedrooms on the ground floor and the remaining of the bedrooms are situated on the first and second floor of the home. There is easy access to the main bus route and the home has transport for the use of the residents. The home is staffed 24 hours a day and is supported by two staff during the night. The home focuses on improving independence through education, work and training opportunities. The range of fees, per week are £1,555.00 to £1,773.00 Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 3 hours. Ms Yvette Hanlon, Registered Manager was in attendance, and service users and staff supplied further support and information. Six service users met and five told me about their experiences of the home. Medication records, person centred and care plans were examined. A brief tour of the building was carried out. What the service does well: What has improved since the last inspection? All the requirements from the last inspection have been met. The home now ensures that accident/incidents are recorded and actioned. All handwritten entries on the medication administration record are countersigned and weekly fire testing is taking place. Specific quality assurance information for Seaview is in place, although the service user questionnaires are quite complicated and would benefit from further review. Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 6 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. Seaview DS0000023589.V308282.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 Seaview DS0000023589.V308282.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The overall quality of this outcome group is good. This judgement has been made using available evidence including a visit to the service. Service users needs are fully assessed prior to admission. EVIDENCE: The newest service user advised they made a positive decision to move here. They said they are really happy having made the decision to come to Seaview, and feel that staff help to make right decisions. Developmental aspirations are well supported. Seaview DS0000023589.V308282.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9, 10 The overall quality of this outcome group is adequate. This judgement has been made using available evidence including a visit to the service. Support planning is reasonable, but updating changes to care plans need improvement. Decision making is well supported. Risk management generally opens up service user opportunities to develop skills. Staff awareness of handling sensitive service user information needs improvement. Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 10 EVIDENCE: Individual support plans draw out strengths and needs. A person centred plan system is currently being implemented, which the manager must ensure stays ‘live’ and gets completed. Reviewing is frequent, and needs are clearly being met, however review data is not being used to update the support plans, which could lead to inconsistencies. Decision making is generally very well supported. Service users are supported to take control of their personal affairs and use the company policies. Feedback indicated that the manager and key workers were really supportive of individual life decisions. Risk taking is generally well supported. Staff, enable service users to fulfil their ambitions; they generally have a healthy attitude and ethos to increasing opportunities. Some perceived ‘health and safety’ risks are preventing service users from regular participation in meal preparation, but after discussion, these are likely to be resolved speedily. Staff were given lots of praise by service users, who said that they trusted them. However, staff upon returning from a supported appointment freely discussed what had gone on, in the presence of other service users . Staff must remember that although the house has a commendably happy, easygoing atmosphere, this is still a shared environment, and confidentiality must be respected. Seaview DS0000023589.V308282.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16, 17 The overall quality of this outcome group is good. This judgement has been made using available evidence including a visit to the service. Personal development opportunities are very good, but where possible, more involvement in cooking skills would benefit service users. Education, occupation and community living opportunities are supported very well. Service users are able to get out into the wider community, maintain friendships, relationships and family contact as they so wish. Daily routines encourage an interesting lifestyle in accordance to individual interest. Foodstuffs are to a high quality, and choice is widely available, but service user involvement in general day to day catering needs improvement. Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 12 EVIDENCE: Service users said that they have lots of teaching sessions with staff and through college and groups to learn or better their skills. An area where two service user said they wanted more involvement was generally meal preparation. In discussion with the manager, this restriction had been historic. This needs to be challenged and developed. People need to practice their taught skills regularly and with staff to offer support & increase skills base. Education and occupational opportunities are excellent. The service users said that they had been consulted regarding courses and activities they wanted to do. An 18-month planner of certificated, structured courses was in place, and a staff member took the role of activity co-ordinator to ensure all enrolment took place smoothly. Individual interests were very well supported. Getting out and about in the community is also supported to an excellent level. For more independent service users, support and risk assessments enable regular unsupported outings. Staffing levels enable those who need extra support to get out on a frequent basis too. Service users are welcome to have their friends over to stay and enjoy accessing places where they can widen their social network. Family contact is well supported and service users said that staff would help family get to the home or them to the family. The service users generally dictate daily routines. Most people are keen to get up and get going to activities. Excellent, positive motivators are in place to encourage people to lead a fulfilled, interactive life. A healthy and balanced diet is offered to all service users. Some have particular disorders regarding food, and it is a credit to the staff and management how well people have learnt to cope and manage their particular problems. However, apart from a weekly, planned, cooking session, service users only use the kitchen to make tea and snacks. Staff do not support people to become involved in the preparation of lunch and dinner. Service users said they would like to do more of this, so assessment of this request is recommended. The manager felt that this could be achieved; it is just historical that it has not happened so far. Seaview DS0000023589.V308282.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The overall quality of this outcome group is adequate. This judgement has been made using available evidence including a visit to the service. Personal and healthcare support is well supported, but systems to ensure consistency need improvement. Some issues of medication management need urgent attention. EVIDENCE: Service users say that the personal support they get is what they need. Staff are kind and encourage self care skills. Care plans help support this. Reviewing needs to be more consistent, as information is being lost within a communal logbook. Individual changing needs (progression and regression) needs to be documented in a way that is easily tracked. Healthcare is well supported and people are encouraged, where possible, to take the lead role when visiting professionals. Documented outcomes of visits to various professionals is kept in the individual plan, but also in the communal log book, which needs improvement to ensure data protection and confidentiality compliance. Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 14 Some good practice was seen with medication management, and the requirements from the last inspection had been met. However, an unethical practice was taking place, where use of an underhand substitute was being given in place of an expected prescription item. The manager was unaware of the danger of such practice, which was not documented or agreed as in the person’s best interest. In discussion, the manager agreed that they would consult the care manager, GP etc to take a multi-agency approach to resolve this issue. No service users have control of their own medication, which needs to be assessed, with action taken to support as greater level of control as possible. Service user allergies need to be stated on the administration records, and the dispensing pharmacy updated with such information. A particular system is in place, but sometimes this is not used, and thus handwritten entries have been necessary. Staff have received medication training, but no assessment is in place to monitor the ongoing competency of staff. The manager agreed that this would all be addressed. Weighed up against the other good practice, the overall outcome of this standard is adequate. Seaview DS0000023589.V308282.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The overall quality of this outcome group is good. This judgement has been made using available evidence including a visit to the service. The complaints system is accessible to all service users. Management review of what constitutes adult protection issues needs reviewing to better protect service users. EVIDENCE: Complaints information is available for all service users to access easily. A pictorial guide helps people access this without full support. Five service users said that they felt fine about making complaints and thought staff would help sort out problems. They would approach the manager to voice concerns. Service users feel physically safe and get on well with the staff team. Staff have received adult protection training, but need to weigh up their knowledge against current practice. Regarding the underhand medication substitute (standard 20), it is important that the manager review what constitutes abuse, since service users are at the mercy of covert practice and would rely on staff knowledge to protect their best interests through the adult protection route. Seaview DS0000023589.V308282.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 The overall quality of this outcome group is good. This judgement has been made using available evidence including a visit to the service. The standard of the environment within the home is good providing residents with a comfortable and homely place to live. Laundry facilities are satisfactory and policies and procedures are in place to control the risk of infection. EVIDENCE: The physical environment of the home is good. Service users like the building and can get around it with minimal support. It is in reasonable decorative order, but some areas are quite shabby; the manager says maintenance systems will be addressing this shortly. A freely available garden is well used. Service users are supported to keep their home clean and tidy. Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 The overall quality of this outcome group is good. This judgement has been made using available evidence including a visit to the service. Staff possess a wide range of suitable qualities and qualifications, but must ensure that they preserve service user privacy and dignity at all times. Recruitment practices are in line with good practice. Service users benefit from a staff team who have had a wide range of training. EVIDENCE: Staff demonstrated a wide range of skills supporting service users to make decisions and learn about new things of interest. Improvement for service users involvement in mealtime tasks needs to be built into the staff shift planner. Service users said that staff are kind and know what they are doing. They trust staff to support them in activities and if they have problems. However, staff must ensure that service user privacy and dignity is preserved at all times. Conversing about personal information needs to take place privately. Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 18 Recruitment was discussed with the manager, but no staff files were seen. The process described met with that of the POVA requirements. Induction training links to NVQ awards. A wide range of service user specific training is provided. The manager said that service users will be involved in health and safety training. Seaview DS0000023589.V308282.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 The overall quality of this outcome group is good. This judgement has been made using available evidence including a visit to the service. The manager is efficient and effective, but greater reflective practice would benefit staff and service user development. Quality assurance processes within the home are reasonable. The health and safety of service users and staff is well managed. EVIDENCE: The management of the service is generally very good. Some practices discussed have been in place historically, and a process of periodically reviewing and challenging needs to be factored in. Additionally, it is important the manager keep up to date with best practices and ensure the staff team have such information cascaded to them. Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 20 The formal quality assurance system has been reviewed. The questionnaire aimed at service users is a big improvement, but is possibly asking questions that are too complex. A further review enlisting the help of a communication specialist would be beneficial. Weekly staff and regular service user meetings take place. As above, it is in these forums that practice needs to be discussed to open up greater service user involvement. Health and safety systems and training is in good order. Fire checks are conducted weekly; a good system of monitoring maintenance repairs is in place. Seaview DS0000023589.V308282.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 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 2 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 2 3 X 3 2 LIFESTYLES Standard No Score 11 2 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 X 3 X 3 X X 3 X Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 YA18 YA19 YA11 YA6 Regulation 14 15 12 16 18 13 Requirement Service user plans must be kept up to date and information kept in line with the Data Protection Act. General daily activities (kitchen & cooking) to incorporate service user personal development where possible. Staff ensure service user privacy and dignity is upheld at all times. Underhand substitute medication practice to be assessed for ethical consideration. Staff to be aware of their limitations & review such practice in line with POVA guidelines. Review MAR sheets to contain all relevant information, such as allergies. Ensure medication policy reflects practice. Timescale for action 01/11/06 2 01/12/06 3 4 YA10 YA20 YA23 01/10/06 01/09/06 5 YA20 13 01/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 23 No. 1 2 Refer to Standard YA20 YA39 Good Practice Recommendations Service users to be assessed and supported where possible to take a greater degree of control over their medication. Review the type and style of questions being asked of service users. Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Seaview DS0000023589.V308282.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!