Inspection on 25/07/05 for Sevington Mill Residential Home

This inspection was carried out on 25th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Sevington Mill Residential Home 14/09/06

Sevington Mill Residential Home 30/01/06

Sevington Mill Residential Home 07/02/05

Sevington Mill Residential Home 05/10/04

Sevington Mill Residential Home 17/02/04

Sevington Mill Residential Home 11/12/03

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOME ADULTS 18-65 Stanley House The Downs Chartham Downs Road Chartham, Canterbury Kent CT4 7PS Lead Inspector Terry Bush Unannounced 26/07/05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stanley House Address The Downs, Chartham Downs Road, Chartham, Canterbury, Kent, CT4 7PS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01227 738253 01227 731864 stanleyhouse@mcch.org.uk MCCH Society Limited Mrs Kelly Anne Field Registered Care Home 12 Category(ies) of Care Home for Younger Adults (18-65) with a registration, with number Mental Disorder, 10 and with a Mental Disorder of places (65 ), 2 Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: MD(E) is restricted to those persons whose date of birth are 10.02.1936 and 14.04.1938 Date of last inspection 05/01/05 Brief Description of the Service: Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that was conducted during the late afternoon and early evening of one day. There were nine service users being accommodated in the home at the time. Four staff provided their direct care needs. There was an additional member of staff on duty who was responsible for the preparation of meals and the cleanliness of the food preparation area and safe storage of food. This person also acted as a focus for training service users in gaining independence and experience in food and meal preparation. The inspector spoke individually with three members of the staff to gauge their understanding of their responsibilities and roles within the home. They were able to provide appropriate information as a basis upon which the inspector was able to conduct the inspection process and focus upon key issues and standards. In addition, the inspector spoke with three residents in a group and then with four residents on an individual basis. He was able to join all the residents whilst they had their main evening meal and exchange general social banter about events that had occurred during the day; individual stories about recollections of past experiences and some future aspirations of some individual service users. The occurrence was also used to observe the staff interacting with the client group and with individuals presenting some mild challenging behaviour. What the service does well: What has improved since the last inspection? What they could do better: There were no issues from the standards examined that the inspector could identify for improvement. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 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. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,4 and 5 The aspirations, wishes and needs of the service users in the home are regularly assessed. Prospective residents to the home are given the opportunity to visit. This can vary according to the nature of the presenting needs and the understanding of the service user. A contract of occupation and the terms and conditions of rights and responsibilities of the service user and the company is provided to both parties as an agreement. EVIDENCE: Assessments on all the service users are regularly undertaken as part of the care package offered in this home. These can take a variety of forms. Much depends upon the presenting behaviour of the service user or changes identified in their care needs. Often assessments are attended by a variety of professionals who have an interest or input into the care planning through the assessment process. Invariable, the assessment is attended by the service user and a person representing their interests and rights. The nature of the content of any assessment depends upon the reasons for its purpose. Irrespectively, the assessment always considers a service user’s opinion and wishes. Where a particular aspiration is expressed by a service user, and is realistic, plans are built round for the achievement of this. When aspirations are set too high, the assessment process is sometimes used to reinforce the achievable parts of the demand. The manager uses the assessment of any one of the residents to identify shortfalls in the delivery of Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 9 care in the home. The findings are then incorporated in a management strategy for the future provision of care. Prospective service users undergo a process of admission. This is set out in key stages in a written policy and procedure. Despite this the stages are not necessarily taken in sequential order. This is made flexible to accommodate a service user’s particular wishes, idiosyncrasies, understanding and presenting problems. Part of the process incorporates a visit or perhaps a group of visits. The functions of these are established from the outset as an occasion for the service user to experience life in the home. They may have a particular purpose and the time span for these vary greatly depending on the factors mentioned earlier in this report. The visit/s are an essential part of an initial assessment where all parties, the home, the representatives and the service user, can interact in an experimental way to establish whether the home meets the care needs, or whether there are likely shortfalls in the delivery of those care needs. The home uses this process well to determine projected care needs and probable training input and further resources for care staff. Once a prospective service user has been identified, their representative and themselves are furnished with a written contract. This clearly sets out the rights and responsibilities of all the parties involved in the placement. It also sets out the circumstances by which occupation of the home can be terminated. This does not undermine current civil or criminal legislation. From time to time, the residential contracts are reviewed to keep pace with changing legislation, but more likely to review the placement fees. The latter is dealt with on an annual basis. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 and 10. Service users know that their personal goals are reflected in their individual plans and that potential risks are managed. They are also aware that their views are listened to and that their records will be kept securely thus maintaining confidentiality. EVIDENCE: Some of the service users were able to express themselves well about their life in the home. They were all acquainted with their personal records and understood the reasons for their maintenance. Some had made their own contribution to the content of their records, whilst others remained ambivalent about the record’s existence. The records were kept in a secure location in the main office used by the staff. They were well put together and in good order. Information about individuals was easily obtained and appropriately indexed. Entries about individual service users were cross-referenced with other records where appropriate. These could be audited through the inspection process and referred back to the service user for verification. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 11 The home conducts a key worker system. The shortcomings of such a system are considered. This is particularly poignant when service users identify in an alternative staff member a natural rapport of interaction that benefits their progress and welfare. This is not over ridden by the key worker system. In such instances the key worker tends to become a secondary and in some instances a perfunctory role, although remains fundamental to the basic care provision towards a service user. In this way, a service user is provided with a good degree of help and assistance to accomplish a meaningful identity and life within the home. This process is extended and complemented when the client group are empowered through a regularly held house/group meeting. The service users are encouraged to assert their decisions and control the day to day conduct of the home, thereby having influence upon most aspects of their life within the home. Service users being exposed to responsible risk is considered a natural extension of being able to live a meaningful and independent life in the home. Each of the service users are assessed for risk in all activities they undertake in the home, or when partaking in external events. This is documented and where appropriate, incorporated in an individual’s care planning. The assessments are regularly reviewed, amended and monitored. The service users are conscious of risk and this is openly discussed with them to ensure they understand any limitations placed on their independence and lives. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17 The meals in this home are good. They offer service users choice, variety and special diets. EVIDENCE: At the time of the inspection the service users were provided with a main meal. The inspector was able to see that it was wholesome and appealing. It was provided in an ambient environment that encouraged social interaction. The staff attended the event and discretely assisted some service users where appropriate. Records relating to the provision of food were examined. They revealed that the meals were provided in enough variety to ensure each person received a balanced diet. When a service user needed a specialised diet, a separate record was kept and maintained. Similarly, if a service user had a meal alternative to that provided on the menu record, this was recorded separately. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 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 standard(s) 20 At the time of this inspection, none of the service users administered their own medication. EVIDENCE: The individual records, relating to the service users, each indicated that selfadministration of their medication was considered when assessments of their care needs was undertaken. This was reviewed from time to time and monitored regularly through an alternative process when the key worker for a service user was formally supervised. The service users seen by the inspector were able to confirm that issues relating to their medication were discussed with them and invariably formed part of their formal case reviews. When a decision was made that prevented a service user’s right to self medicate, this was clearly documented and the reasons were made known. The policies and procedures relating to the administration of medication appropriately safeguarded the service users’ welfare. The procedures contained adequate instruction to the staff that ensures awareness of the risks and how to evaluate them. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 A complaint procedure is provided to service users and is incorporated in their individual service agreement. They know that their views will be listened to and acted upon. The staff are aware of all aspects relating to the complaint procedure and whistle blowing procedures and its use in adult protection. EVIDENCE: At the time of the inspection there were no current complaints recorded or being investigated. The records revealed that when complaints had been made they had been investigated and a report was made available to the person originally initiating it. The complaint procedure had three stages The abuse documentations collated by the manager are used as a policy and procedure in the home. They do not undermine a service user’s civil or criminal rights to make their own representation to appropriate authorities. The documents provide clear guidelines to the staff, visitors, representatives and the service users about abuse issues. These are complemented by a complaint procedure and a whistle-blowing policy. All these documents are readily available to persons with an interest in the home. The staff regularly attend training programmes that address abuse issues and the protection of potentially vulnerable adults. The service users are confident that whenever they complain about aspects of their care or about the conduct of the home, these are treated seriously. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, and 30 The home provides a homely, comfortable and safe environment for the service users. This has been accomplished through recent investment into the cosmetic improvements throughout the home. Everyone accommodated in the home has their own bedroom. There are sufficient toilets and bathrooms to meet the presenting needs of all the residents. There is appropriate special equipment to ensure service users’ independence is treated as paramount. The practices conducted in the home indicate that it is hygienic and clean. EVIDENCE: The home has recently undergone a significant refurbishment and redecoration in all the communal areas. This has been a considered exercise that provides a good standard of cosmetic décor and refurbishment that is welcoming, homely and comfortable. There are three sitting rooms in the home. Each is differently furnished and decorated to suit their intended purposes. One room is used for service users to smoke. Another is a main lounge that incorporates in-house audio and visual entertainment facilities. The remaining room is used as a quite area, although it is juxtaposed to the main lounge and can be used as an extension for special occasions through a common double doorway. The main Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 16 lounge has access onto an external patio area that has a magnificent view overlooking the local downs. There are two adjoining areas used for dining and recreational purposes. These are brightly coloured and offer an ambient area for both functions. It enables some service users the facility to pursue group indoor activities, hobbies and interests. Throughout the house there are items that enhance and adorn the rooms. These reflect the different personalities, characters, interests and cultures of the resident group. Similarly, the service users’ own rooms are decorated and arranged to reflect their choice. Each room indicates the identity of the occupant. This is achieved according to their interests, cultural identity, character or personality. The rooms used by the residents are sufficient for some of them to undertake a variety of indoor activities and interests in elected solitude and independence. There are four bathrooms and two shower rooms in the house. These are appropriately placed to provide reasonable access to all the service users in relation to the location of their individual rooms. The facilities are appropriately equipped to maintain privacy and meet the presenting needs of the current resident group. There are eight toilets in the home. These are strategically placed to provide good access for each of the service users in relation to their bedrooms. Some are equipped to meet the needs of persons with mobility problems. One service user in the home has mobility problems and has access to some of the facilities to enable a degree of independence with minimal interference or assistance from the care staff. The records relating to the indirect safety of the service users and visitors were examined. They indicated that health and safety aspects of the building were given regular attention. The records were up to date and accurate. A visual inspection of some of the safety facilities in the house revealed that the records were accurate. There were staff employed to clean the home, although there was an expectation that service users would contribute to this aspect of care in the home. This necessitated that cleaning was conducted according to a rota. The procedures of cleaning the home, and the regularity of this indicated that the home was as hygienic as could possible be accomplished. Overall, the home appeared clean and hygienic. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, and 35 The staff have clearly identified job descriptions that clarify their role and responsibility. The home ensures that the staff are competent and appropriately qualified to fulfil their roles and responsibilities. Part of the training ensures that the staff form part of an effective team. All of these issues support and benefit the service users. The home safeguards the service users’ welfare with appropriate procedures and policies on the selection and recruitment of appropriate staff. The presenting needs of the service users are identified and met with appropriately trained staff. The home conducts good support and supervision networks for the care staff. EVIDENCE: The home has established appropriate job descriptions for each job function in the home. These are interlinked but clearly define a role for each of the staff to identify and secure the responsibilities of this role. The service users were able to relate to the different roles and responsibilities of the staff because they were established in the ethos and regime in the home. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 18 The service users had formed their own communication systems relating to the staff roles with each of their responsibilities. This was an effective process and displayed the cohesive nature of the client group in the home reinforcing their expectations of the staff responsibilities along with their roles. The home has a good training programme for the care staff. This not only considers the statutory obligations for each staff member, but is enhanced enough to enable staff to undertake training in areas that relate to the different presenting needs of the service users. There is seventeen care staff employed in the home. Nine of them have completed national vocational qualifications to level three. Many of the staff have complemented this training with specific qualifications that relate to individual client needs. In principle, this means that the home can cope with a wide range of care problems. The staff skill mix and their ability to interact with each other was seen by the inspector whilst observing aspects of the delivery of care to the service users. This seemed to meet the diversity of needs for the current service user group. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 40 and 42 The home is well run and is organised in the best interests of the service users. This is partly accomplished by the home’s policies and procedures. The health, safety and welfare of the service users is given paramount consideration in the conduct of the home and safeguards their welfare. EVIDENCE: The home has a good management regime and strategy that has been established over a period of time. This is augmented and maintained through regular household/residents’ meetings from which the home benefits with contributions through this process in the way things are run. It also helps to establish service users accountable for the nature of the conduct of the home and the management of themselves. In this way issues do not tend to be overlooked and conflate to form an overall culture of wellbeing and accomplishment. The outcome is that the home appears to run itself and this is generally appreciated by the service users. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 20 It also means that the input from the staff seems to be fairly low key and their interference into the service users’ everyday affairs minimal. Of course, this is not the case. The home’s ethos and regime is being conducted effectively and efficiently through its management systems. This tends to reduce confrontation and creates the effect of harmony from which everyone in the home benefits. The staff have a professional approach to their work and this is reflected in the delivery of care. The policies and procedures provide the staff with confidence to carry out their duties. They safeguard the service users and the staff by reinforcing good care practice. Most of the service users have some knowledge of the home’s working procedures. This particularly relates to making complaints, equality and discrimination. The records relating to the indirect health and safety of the service users were examined. They were well maintained and current. Monthly visits from responsible persons representing the registered persons ensure that health and safety issues are regularly addressed and attended. This actively promotes and protects the service users from irresponsible risk. Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x x x x x x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stanley House Score x x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x 3 x H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 22 None 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 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 Good Practice Recommendations Stanley House H56-H05 S23713 Stanley House V238338 260705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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. 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