Inspection on 28/11/05 for Southlands

This inspection was carried out on 28th November 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Southlands 24/07/06

Southlands 03/08/05

Southlands 23/02/05

Southlands 15/11/04

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 Southlands Southlands East Street Harrietsham Maidstone Kent ME17 1HH Lead Inspector Mrs Ann Block Announced Inspection 28th November 2005 02:48 Southlands DS0000023871.V256992.R01.S.doc Version 5.0 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 Southlands DS0000023871.V256992.R01.S.doc Version 5.0 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. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Southlands Address 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) Southlands East Street Harrietsham Maidstone Kent ME17 1HH 01622 858713 01622 858713 southlands@counticare.co.uk Counticare Limited Mrs Virginia Anne Harvey Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd August 2005 Brief Description of the Service: Southlands is a modern detached property with an adjoining garage, standing in its own grounds. It provides accommodation for 6 adults with learning disabilities some of who may also have mental health problems, and is staffed on a 24 hour basis. The current resident group are all female. Accommodation is on two floors with service users bedrooms being located on both ground and first floors. The house has recently undergone extensive refurbishment and upgrading. The service is owned and managed by Counticare who own a number of services in the area and offer a day service facility in Folkestone. The home is located in the village of Harrietsham with easy access to public transport on the main A20 Ashford to Maidstone Road nearby. The nearest shops and other amenities for example church, pub and shops are within a short walking distance. The home has facilities for car parking for approximately 5 cars at the front of the building. There is a large patio and a large grassed garden to the rear that backs on to open farmland. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The commission was represented by regulatory inspector Ann Block who carried out an announced inspection of Southlands between 2.48 and 8 25 pm on 28th November 2005. During the visit, residents came back from their day activities and were happy to chat with the inspector. They talked of things that had happened to them including health care, holidays, friendships and activities. Staff on duty talked in private and whilst working with residents. Assessments against standards were made from conversation, records and general observation. The atmosphere was welcoming and relaxed with residents showing how comfortable they are in the home. The service combines professional standards in practice and record keeping with a good quality of life for residents. As part of the announced inspection process, comment cards were received from residents, relatives and professionals, some views of the service have been reflected in the report. In all but one case, comments were highly complimentary of the service including: ‘I have always found this home very friendly and everyone in it is happy and I have not observed any abuse to service users of staff.’ ‘I remain very impressed with the professionalism and commitment of the staff team to work effectively with a challenging client group’ What the service does well: Residents enjoy a service where their needs will be met as a group and individually. To ensure that care and support will be provided consistently, sound records are maintained, held securely with confidentiality ensured. Residents know they can look at their records and take part in the recording process. Where residents have health or medical needs access to appropriate services will be made with any recommendations followed up. Residents have many opportunities for social and leisure activities at Southlands and external day services with additional planned holidays and outings which they choose. Families and friends can be involved as much as the resident decides. Personal relationships are respected. Residents have an attractive, well maintained, safe, homely and clean house to live in which has recently been Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 6 the subject of extensive upgrading and redecoration. Residents are supported by a well managed, properly recruited and trained staff team who are interested, motivated and committed to providing a high standard of care. The manager is liked and respected, staff and residents are relaxed when talking to her and feel supported. Staff understand each resident, particularly in their keyworker role, and provide a service which acknowledges personal strengths and needs. Good systems are in place to promote safety to residents including documented risk assessments which are carried out in practice. 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. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 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 Southlands DS0000023871.V256992.R01.S.doc Version 5.0 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): 1,2,3,4 & 5 Residents and others have good systems in place to support a planned and appropriate move into the home. EVIDENCE: The resident group has been together for some time with no new admissions. Residents, families and placing agencies have access to accurate, detailed and updated written information about the home. Counticare have a central placements officer as initial contact point. The manager is clear that she would need to make the final decision about any placements at Southlands to ensure the service would be suitable for the applicant and those already living there through a comprehensive assessment process. Any prospective resident would have the chance to ‘test drive’ the service through staged visits. Senior staff in particular have very good skills in working with the client group, other staff are offered in house mentoring and training courses to improve their skills and knowledge. Staff are very enthusiastic about the service and the quality of care provided, which the relaxed and comfortable feeling in the home reflects. Professional advice and support is welcomed with sound joint working practices that have improved the quality of life for residents. Each resident has a contract between themselves and the home which details the rights and responsibilities of the service and the resident. Where the Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 9 service no longer meets the resident’s needs, they will be fully supported to find more suitable accommodation. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 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 the following standard(s): 6,7,8,9 & 10 Residents enjoy a good quality of life where they can be the decision makers. EVIDENCE: Each resident has secure individual records, including a care file, which detail a range of information accessible on a need to know basis. On their return from a shopping trip two residents came to collect their care files so they and staff could record the day together. Care files hold comprehensive, regularly reviewed and updated care and support directions. Both staff and residents work together to meet agreed aims, such as moving towards more independent living. Residents understand this process as they are fully involved in any decision making. Staff also have an excellent understanding of the links between different records, for example, a record in an accident book led to guidelines being set up to reduce the risk of the same situation happening again. Staff were seen to put these guidelines into practice. This clear link between different areas of residents’ lives promotes good, safe and consistent care and support. Each resident has a keyworker who takes a lead responsibility for all areas of care and support. Residents knew who their keyworker was, were happy with the relationship and felt very supported by it. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 11 One resident spoke of how she was able to contact two key staff in her life and how much she appreciated this. Residents’ rights to make decisions is seen as fundamental to the service. Staff unitedly uphold residents rights, both in house and in the community. Since the inspector has known the resident group, there have been remarkable developments to self esteem, self confidence, abilities and overall wellbeing. Staff who had worked at the home for some time said it was noticeable how challenging behaviours and incidents affecting the wellbeing of residents had dramatically reduced since the current manager had been in post. Each resident has a programme for the week. Whilst residents are encouraged to honour commitments, they will not be forced or pressured to conform to others opinions of how their lives should be run. The rights of residents as adults with the right to make decisions, including risk taking, are upheld. Staff ensure that the process takes into account the understanding and abilities of individual residents. For example, one resident is being given increased but supported freedom to access the community as part of her wish to become more independent. Other residents who have less well developed skills have a higher level of direct support. The stage each resident is at in their overall development is evidenced through records. Risks therefore are very well managed through a sound risk assessment process in which the residents, and where necessary professionals, are fully consulted. Residents are able to manage their finances, if necessary with staff support. A resident spoke of how she managed her finances using a bank cash card. Expenditure made on behalf of residents is very clearly recorded, ensuring the residents affairs are properly managed. Systems are in place through Head Office for those needing a higher level of assistance in dealing with benefits. Confidentiality is very well maintained. Both residents and staff uphold the right for personal information to remain within a need to know basis. This may mean that family and friends will not be party to information which the resident chooses not to share. Staff are aware of circumstances in which information would have to be shared to safeguard the residents, for example under adult protection procedures. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 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 the following standard(s): 11,12,13,14,15,16 & 17 Residents have every opportunity to live a fulfilled, responsible, valued and socially active life. EVIDENCE: The aim is for all residents to have as ‘normal’ as life as possible with an excellent range of opportunities to develop and improve confidence, independent living, education, concentration and communication skills amongst others. Each resident has goals which they help to choose. Many of these goals will relate to personal development, including moving on to more independent accommodation if practical. Staff use records to evidence progress towards goals so that each resident can see the progress they are making. Residents again clearly showed how this increased confidence for them. Residents have many opportunities to access educational, recreational and social events both within Counticare and the wider community. On the day of inspection two residents had been with two staff to Maidstone shopping, three had been to the day service in Folkestone and one had been to college. The Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 13 two who went shopping were very pleased to show off their purchases, especially a rather wonderful teddy, and Christmas and birthday presents they had bought for friends. The others talked about what they had done that day, including showing the amount of paint over one residents hands. One spoke of her woodwork course where she is making a garden table. Residents also attend and run social events including running a weekly disco in Maidstone. The group are very supportive of each other and recognise each person strengths. Many friendships have been made through social events. One resident uses public transport, others can use the minibus which is based at Southlands. Residents have access to a range of other activities such as riding, trampolining, canoeing, trips out, including to the local pub, and holidays. Residents were already discussing next years holidays, where they fancied going, who with and what they would be able to do there. Residents commented on how much they had enjoyed last summers holidays. Residents are encouraged to keep contact with their families and friends. Relatives are able to talk though any issues with the manager or just have a chat. Information is only shared with families in line with the resident’s best interests, often as part of a review meeting. A number of residents make home visits. Personal relationships are very well supported, with professional advice accessed as necessary. Two boyfriends had come for lunch the previous weekend, one resident was looking forward to taking her boyfriend out for a birthday treat. Staff understand the right of residents to form close relationships, they ensure that professional advice is obtained to support the resident to make the right decisions about their relationship. Residents spoke of how much they cared for their boyfriends and it was clear that they gained a lot of comfort in having such personal relationships. Staff ensure that the resident is not placed at unacceptable risk in such situations. Privacy is well maintained. Residents say that they make the decision who comes into their room. Communal areas are open to all. Residents who benefit from holding keys to their room have one. Residents have mail given to them unopened. Some will be gently supervised to deal appropriately with mail by their keyworker. Meals and snacks are very much as would be found in any household. Shopping is done weekly with staff assistance. The fridge held a range of fresh foods, with others in the freezer. The aim is for a range of foods to be purchased from which residents can choose what they want to eat at the time. On the day of inspection the main option was pizza, jacket potato and three different fresh vegetables. Some residents had the whole meal, one had cold meat with a jacket potato. Fresh fruit and yoghurts are always available for dessert. One resident put a name label on a can of soup which she was going to heat up the following day to take to work in a thermos ‘as it was cold weather’. Residents fully assist in food preparation and can help themselves to drinks from the fridge. Certain practices have to be in place to restrict access to food which are understood by the group. Staff support residents to follow a Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 14 healthy diet and to meet any special dietary needs. Food records are held to track nutrition for each person. Where there are concerns about weight specialist advice is sought. Residents like the new dining room and take turns to lay it ready for dinner. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 15 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 & 21 Residents’ health and care needs are very well managed and take into account their individual preferences and needs. EVIDENCE: Residents rights to maintain dignity are respected in all care and support practices. Records of individual preferences are recorded for continuity. Currently there are no male staff employed at Southlands, whilst there is no restriction to employing male staff, the views of a minority of residents make it easier to have female staff giving personal care. To promote the safety of both residents and staff, a gender and limits of personal care policy has been written. Residents have flexibility in their routines. Often routines are the preferred option for the resident and to alter a routine without good reason can cause anxiety. Staff are fully aware of such situations and aim to minimise such occurrences. Similarly, as each person is in a care environment due to their need for personal, emotional and practical support, behaviours have potential to challenge other residents. Generally residents and staff are fully aware of situations which may lead to problems and use guidelines to reduce the impact on anyone else. One resident spoke of how she reacted to certain situations and what caused her stress. Another was aware that the period leading up to Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 16 Christmas caused her anxiety, staff were also aware of this and were supporting her to manage the stress. Professional input is also used to devise guidelines and make suggestions to benefit the resident and the handling of difficult situations. As mentioned earlier, there has been an overall reduction in challenging behaviours. Residents felt the keyworker system is good. The manager observes relationships between staff and residents and allocates the keyworker using that information. Keyworkers take a lead in all aspects of the residents life in the home, making sure appointments are made, reviews take place, care plans are updated and being the key contact. Staff are aware of the mental and physical health needs of each resident and of indicators of additional health concerns. Where necessary, appointments will be made with relevant professionals. A resident spoke of a recent diagnosis resulting from assessments initiated by the current manager. She spoke of feeling reassured that her problems had a name and were the reason for some of her as she called it ‘behaviours’. Care is taken not to cause undue distress during physical investigations by advising the resident and using strategies to manage the situation to reduce concern. A resident spoke of how this had been managed in her case. Where professional advice is given this is recorded and expected to be followed by all staff. Residents share in understanding and dealing with health issues and make decisions as their capacity allows. Medication practices are good with designated secure storage. Records to evidence administration are completed accurately. Staff administering medication may only do so after they have had suitable training. A member of staff explained that she could observe medication but not administer it, as she hadn’t had the training yet. Residents may part or fully self medicate within a risk assessment process. One resident said she had originally had problems using the blister pack monitored dosage system but was now used to it, only having difficulty when she was feeling under pressure. Homely and as required medication is separately recorded to monitor usage. Wishes in the event of death are recorded. Residents are supported in dealing with bereavements. One spoke of possible funeral arrangements and how she was able to maintain contact with a loved one during the aging process. Staff and residents showed compassion in supporting the current situation. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 17 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 Residents are able to raise concerns and be assured that these concerns will be listened to and acted on. They are protected as far as possible from the risks of harm or abuse, small amendments to the system would further enhance this. EVIDENCE: Residents have access to a range of people to whom they can complain. On a day-to-day basis residents feel comfortable to talk to staff and the manager. One resident spoke of how she was able to phone two particular staff when she had any concerns and how supportive they were. Residents have also found their care manager a useful link when they have concerns. Relatives and friends have opportunities to make comment about matters brought up outside the home environment, often through phone calls but also during reviews. In all complaints the wellbeing of the resident will be paramount. For accountability, a record of complaints is held which maintains confidentiality. Formal complaint procedures are provided with contact detail. The latest copy of the Kent and Medway joint working adult protection protocol has been obtained. A Counticare policy on adult protection has been set out. This document records that the home manager will be key contact for alerts in house and then must contact the placements director who will make a decision whether an alert should be raised. No processes for use in the director’s absence are recorded. Processes for raising an alert regarding incidents in the community are separately described. All staff have a good awareness of what constitutes abuse, a question on abuse is included in staff recruitment interviews. Staff have knowledge underpinned by formal training and take action where there are any concerns, as they firmly believe in the protection of vulnerable adults. As mentioned earlier, some behaviours of residents have Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 18 potential to be regarded as abuse. Guidelines and practices are in place to minimize such situations and to protect both residents and staff. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 19 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): 24,25,26,27,28,29 & 30 Residents live in a well maintained, homely and safe environment. EVIDENCE: Residents live in a domestic style home which blends in with the local area. Counticare have recently upgraded the property to make it more suitable for residents. As part of this upgrade a designated office, separate dining room, completely refurbished kitchen and laundry rooms, new en-suite staff sleep in room, large communal toilet, enlargement of one bedroom and en-suites to two bedrooms have been provided. Work is continuing to provide an activities room. The ground floor has been recarpeted and redecorated. The upper floor was upgraded last year, work is planned to refurbish the bathrooms. As is usual when such a large building project is carried out, there was disruption to residents’ lives. Staff aimed to minimize the impact on residents and ended up using the best options in finding alternative accommodation for 8 weeks whilst the worst of the work was being done. Residents understood what was happening and are thrilled with the results, again wanting to show the inspector all the new work. The new dining room has left more room in the kitchen. Residents love this new kitchen, they consider there is much more space. Storage in some cupboards has to be secure and is accessed with a magnet lock. One resident has her own magnet lock to use. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 20 The home was lovely and warm, draught free, bright and homely. As part of the refurbishment temperature control valves were fitted to hot water outlets to reduce the risk of scalds. Each resident has their own room which they can personalise to their choice. One resident indicated how much she was looking forward to her new easy chair being delivered, she chose a cream colour which, with orange, are her favourite colours. Another resident proudly showed off her new curtains which had been designed to reduce non accidental damage. Residents use their rooms to entertain friends or just be in private to listen to music or watch TV. One spoke of spending a lot of time in her room as she liked this privacy, and was able to have a little fridge and kettle bought by her parents. A ‘baby monitoring’ system is used for one resident with her express agreement. Other residents are able to alert staff to any problem in person. A phone on the main office line is in the dining room and can be used in private, a separate phone line is to be provided when the activity room is finished. This will ensure residents can make phone calls in full privacy. One resident has a mobile phone. Residents use the garden which has lawn, a patio area and a lovely view over the countryside. As there is a door leading from the kitchen residents can easily take a drink or meal outside. Aids to living are provided with any potential risks to dignity or privacy discussed and recorded. At the time of inspection the home was clean and well maintained. A fire risk assessment has been carried out and is kept updated. Staff and residents are reminded to work to good food hygiene standards to prevent the risk of illness. Staff work with residents to keep the home clean. One housekeeper has transferred to being a support worker as she enjoyed being with the residents so much, another housekeeper had been employed but left by mutual agreement. A replacement was stated as being very hard to find. The new laundry provides for more space with a washing machine, tumble drier and storage. Residents are now better able to assist with their own laundry if they wish. The risks of cross infection are reduced by use of a designated hand washbasin. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 21 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): 31,32,33,34,35 & 36 Residents have motivated, trained and committed staff who provide friendship, care and support. Updates to control and restraint training would better protect residents and staff. EVIDENCE: Residents consider there are sufficient staff on duty to assist them with personal care and with social activities. They like the staff and have a good rapport with them. The majority of staff work 35 hours a week which gives flexibility for working overtime. Staff rosters are adjusted to provide additional staff such as escort or holidays. As in common with a number of care services for adults, there has recently been a turnover of staff with bank staff and overtime is being used to fill the gaps. Residents didn’t feel this had caused them any problems, one spoke of a new member of staff having a horse and of looking forward to a ‘horsy’ day which was being planned. A recently recruited member of staff was already integrated into the ways of the house, got on well with residents and spoke of enjoying the work. Another member of staff said she welcomed any opportunity to work at Southlands, the residents were so nice and the home was well run. A senior who came to the home some time ago having had very limited experience in care said that it was the best decision she had ever made. She also mentioned how much she had learned from the current manager. She had gained experience, skills and training to fit her for the senior role. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 22 Counticare provide training with a designated training officer. Staff commented that some courses were excellent whereas they preferred to access other courses externally. Some Counticare training is provided as ‘workshops’ rather than certificated training. Staff mentioned that a number of courses had been cancelled leaving a deficit in key training which was needed to work effectively and safely with the client group. There is a definite need for all staff to have formal control and restraint training such as SCIP training, and for all new staff to undertake this training within two months of their start date. Training generally covers mandatory and client specific training. All staff follow a structured and recorded induction. Communication between staff and from management is good using communication books, handovers and team meetings. There is a sound staff supervision and appraisal system for which detailed records are held. Good recruitment practice promotes safety of residents by use of an application form, CRB and POVA checks, recorded interview and checks on employment history as confirmed by a newly recruited member of staff and records. A new member of staff will only commence work once full and satisfactory responses have been obtained. The philosophy of the service is that staff work with and support residents, not simply to do things for them. Staff practices are monitored to ensure this happens. That this systems benefits residents is shown by the marked improvement to confidence, skills development and reduction in behaviours which might challenge. Staff said that relationships between the staff team was good with good communication. Staff at all levels will challenge practices which fall below the expected high standards, including use of disciplinary and grievance, adult protection and POVA procedures. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 23 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): 37,38,39,40,41,42 & 43 Residents benefit from a well managed, safe and well maintained service EVIDENCE: The manager holds the NVQ 4 and Registered Managers Award. She ensures that she and all staff update their skills and knowledge on a regular basis. Staff are delegated achievable tasks to develop their skills and understanding, they welcomed this opportunity. Residents and staff spoke very highly of the manager as evidenced to Counticare senior managers recently. Residents said how much they liked her and felt comfortable taking to her. There is an excellent sense of ‘group’ and openness in the home. Whilst staff and residents understand the management structure and who can make the final decision regarding the service, each person has the right to voice their opinion. Regular resident and team meetings are held. These plus joint resident and staff outings promote group working. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 24 The views of families, professionals and friends are actively sought to monitor the quality of service provision. Counticare send out questionnaires as part of monitoring the company’s performance. The manager has devised and will be sending out her own questionnaires to use to monitor Southlands performance. The manager uses both Counticare and service specific policies to inform practices for staff. As confirmed by staff on duty, all staff are required to sign that they have read and understood policies. Residents are involved in developing in house policies and procedures wherever possible. The high standards of care and support with every indication that residents benefit from a good service are all evidenced by sound record keeping. Records required as part of the regulatory process are well managed and available for inspection. Residents are aware that they have the right to see information about them. Record keeping meets the requirements of the Data Protection Act including an accident record. Records of accidents had been followed up to reduce the risk of a similar accident occurring. Safety notices are displayed. Safety in the home is maintained by regular servicing of supplies and equipment, as evidenced in the service file, updated staff training and comprehensive risk assessments. Responses to new situations further upholds safety. Fire safety is well maintained by staff training, regular fire drills and practices for both staff and residents and periodic testing of fire safety equipment. The maintenance person visits the home weekly and does a walk around check. Staff and residents said that repair requests are carried out promptly. Good food safety is promoted with staff receiving food hygiene awareness training. Residents are reminded of good practice when handling food. Regular monitoring visits by a representative of Counticare takes place with reports prepared. Current insurance certificates were seen on display. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 25 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 3 3 3 3 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 1 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Southlands Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 3 3 DS0000023871.V256992.R01.S.doc Version 5.0 Page 26 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 YA3535.1 Regulation 18.1 Requirement All staff must have the skills and qualifications necessary to work effectively and safely with the client group. This will include that: All staff must have up to date control and restraint training by 31 January 2006 All new staff must have control and restraint training as part of their induction package. This must take place within two months of their appointment. Timescale for action 31/01/06 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 YA2323.2 Refer to Standard Good Practice Recommendations The system for making an in house adult protection alert should be reviewed to ensure alerts are made promptly ensuring that any final decisions about the outcome are made through the agreed Kent and Medway adult DS0000023871.V256992.R01.S.doc Version 5.0 Page 27 Southlands protection joint working procedure. 2 YA2626.2 As planned, consideration should be given to providing a phone separate from the main office line, which can be used in private. Southlands DS0000023871.V256992.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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