Inspection on 03/08/05 for Southlands

This inspection was carried out on 3rd August 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also 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 28/11/05

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

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

CARE HOME ADULTS 18-65 Southlands East Street Harrietsham Maidstone Kent ME17 1HH Lead Inspector Ann Block Unannounced 03 August 2005 15:15 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. Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Southlands Address East Street Harrietsham Maidstone Kent ME17 1HH 01622 858713 01622 858713 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) Counticare Limited Mrs Virginia Anne Harvey CRH Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23 February 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 and is staffed on a 24 hour basis. 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 H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 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 unannounced inspection of Southlands between 3 15 and 6 25 pm on 3rd August 2005. During this 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, activities and the work on the house. Staff on duty chatted as they worked to support residents to prepare tea. 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. What the service does well: What has improved since the last inspection? Systems are in place to ensure that money held on behalf of residents is properly managed using individual named accounts under one Company account. The home has been redecorated, upgraded and refurbished giving a staff en-suite sleep in room, improved kitchen and laundry facilities and a separate dining room. The safety of residents is enhanced as records of staff Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 6 and residents now include a recent photograph. Safety is further maintained by the use of safety devices on hot water outlets. 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 H56-H06 S23871 Southlands V236836 030805 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 Southlands H56-H06 S23871 Southlands V236836 030805 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) 1,3 Residents gain from a service with a skilled workforce which meets assessed needs. EVIDENCE: The resident group has been together for some time with no new admissions. Residents, families and placing agencies have access to accurate and detailed 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. Staff work well with residents and undertake ongoing training and skills development to ensure individual needs are being met. 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. Where the service no longer meets the resident’s needs, they will be fully supported to find more suitable accommodation. Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 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 standard(s) 6,7,8,9 & 10 Residents’ quality of life is enhanced through well assessed and documented practices. EVIDENCE: Each resident has individual secure records, including a care file, which detail a range of information accessible on a need to know basis. There is an excellent understanding of the usefulness of accurate personal records. Residents have full input into their care files which are updated as necessary. Needs are well met through information shared within the staff team, ensuring that staff work consistently and have the most up to date information. Staff understand the links between documents and how these are to be put into practice. Informed risk taking is encouraged with excellent recorded risk assessments and action taken to reduce or remove the risk. As an example, one resident went out to post a letter and followed the agreed guidelines to promote safety. Any perception of risk will be followed up with a risk assessment. Staff are committed to maintaining confidentiality of information and challenge any breaches within the team or by others. Residents and staff fully acknowledge the rights of residents to make decisions about their lives. Whilst daily diaries are planned with residents, personal preferences at the time will be Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 10 acknowledged. With the right to makes choices, residents are reminded about their responsibilities with staff promoting a healthy and fulfilled life. Residents are able to manage their finances, if necessary with staff support. Systems are in place through Head Office for those needing a higher level of assistance. Residents say they are able to tell staff what they think of the service, often in meetings. Opinions made during the day are responded to and action taken as appropriate. Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 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 standard(s) 11,12,13,14,15,16 & 17 Residents enjoy a varied 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 clearly showed how this increased confidence for them. Social skills are worked with, the latest project being a weekly disco in Maidstone which is run by residents. The group are very supportive of each other and recognise each person strengths. Many friendships have been made through social events. Residents have access to a range of other activities such as the day service at Folkestone, riding, trampolining, canoeing, trips out, Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 12 including to the local pub, and holidays. During the recent refurbishment of the home, three staff and the resident group had a three week holiday in the Isle of Wight where they had a wonderful time including staying up late for the disco. Some residents may be taking a holiday abroad in the autumn. One resident uses public transport, others can use the recently purchased minibus which is based at Southlands. 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. Often friends come to the house for a meal or stay over. Privacy in this, and in general life in the home, is well maintained. Residents say that they make the decision who comes into their room. Residents who benefit from holding keys to their room have one. 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. As an example of how this works, on the evening of this inspection, two residents had crispbread and spread, whilst others had tuna burgers with vegetables. On a recent evening, it was said that five different foods had been prepared. 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 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 speciality advice is sought. Southlands H56-H06 S23871 Southlands V236836 030805 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) 18,19 & 20 Residents’ care and medical needs are managed to promote a good quality of physical and mental health. EVIDENCE: Residents rights to maintain dignity and respected in all care and support practices. A senior support worker is devising gender and limits of personal care policies applicable to Southlands residents. Records of individual preferences are recorded for continuity. Each resident has a named support worker (keyworker), residents consider this system works well. The manager watches to see how relationships between new staff and residents develop and may then use this information to choose who will be keyworker. Keyworkers are expected as part of their role to uphold the rights of ‘their’ resident, to make sure amongst other things that appointments are made and attended, the resident is listened to, personal choices are met and records are maintained. All staff are very aware of any associated health conditions or of indicators of additional health concerns and will take action. Health and auxiliary professionals are accessed and are expected to work with the resident to improve health. 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. Where professional advice is given this is Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 14 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. Residents may part or fully self medicate within a risk assessment process. The member of staff administering medication evidenced her training from West Kent College by following good practice, including monitoring previous records of administration. Homely and as required medication is separately recorded to monitor usage. Individual sun protection lotion had been obtained for the recent heatwave. Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 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 standard(s) 22 & 23 Residents’ rights to feel safe, with opportunities to complain, are upheld by the sound systems in place. 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. Relatives and friends have opportunities to make comment about matters brought up outside the home environment. Feedback is provided. For accountability, a record of complaints is held which maintains confidentiality. Formal complaint procedures are provided, one complaint needs minor amendments relating to accessing the commission. The latest copy of the Kent and Medway joint working adult protection protocol has been obtained. 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. Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 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 standard(s) 24,25,26,27,28,29 & 30 Residents have a clean, attractive and well maintained house in which to live. 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 and an en-suite to a bedroom have been provided. Work is continuing which will give another en-suite with an enlarged room and an activities room. The ground floor has been recarpeted and redecorated. The upper floor had been upgraded last year, work is planned to refurbish the bathrooms. Residents went away for the period when the main work was carried out and were reported as being absolutely thrilled when they returned. One resident was really pleased with her en-suite and another can’t wait for hers. The new dining room has left more room in the kitchen with plenty of workspace. Residents said they liked the new cupboards, much better they said than the old scruffy ones. They had all familiarised themselves where things were stored. A part of the refurbishment Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 17 temperature control valves have been fitted to hot water outlets. Each resident has their own room which they can personalise to their choice. Residents use their rooms to entertain friends or just be in private to listen to music or watch TV. 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. A housekeeper works with staff and residents to keep the home clean. Given that building work is still underway the home was very clean and hygienic. The new laundry provides for more space with a washing machine, tumble drier and storage. There is a sink but it is not a designated hand washing sink as required to reduce the risks of cross infection. As intended, a designated hand washing sink must be fitted. Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35 & 36 Residents are supported to achieve their goals by a team of professional, reliable and dedicated staff. EVIDENCE: Residents consider there are sufficient staff on duty to assist them with personal care and with social activities. The majority of staff work 35 hours a week which gives flexibility for working overtime. One vacancy is currently being covered in this manner. Residents like the staff and have a good rapport with them. A housekeeper overseas shopping and cleaning with residents. Counticare provide training with a designated training officer. Staff commented that some courses were excellent whereas they preferred to access other courses externally. Training covers mandatory and client specific training, especially training which helps staff to understand individual needs. All staff follow a structured and recorded induction. There is a good 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. A newly recruited 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. Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 19 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 as evidenced in the communication book. Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 20 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) 37,28,39,40,41,42 & 43 Residents’ safety in the home in maintained through a well managed service. EVIDENCE: The manager has recently completed her 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. The manager uses both Counticare and service specific policies to inform practices for staff, all staff are required to sign that they have read and understood policies. 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 meetings are held. These plus joint resident and staff outings promote group working. The views of families, professional and friends are actively sought to monitor the quality of service provision. That the service is for the Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 21 benefit of residents is clear. Safety in the home is maintained by regular servicing of supplies and equipment, updated staff training and comprehensive risk assessments. Responses to new situations further upholds safety. Regular monitoring visits by a representative of Counticare takes place with reports prepared. Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 22 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 x 3 x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 1 Standard No 11 12 13 14 15 16 17 3 2 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Southlands Score 2 3 3 x Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 3 3 3 H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 23 Yes 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 YA30 Regulation 16(2) (e) and (f) Requirement The registered person must provide adequate laundering facilities and ensure that the premises are suitable for purpose in that the home must be developed to ensure that the premises are fit for purpose: · separate hand washing facilities must be provided in the laundry area The building work was intended to provide this facility, it currently has not done so. Timescale for action To be completed by 30 September 2005 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. 2. 3. Refer to Standard 18.1 22.3 26.2 Good Practice Recommendations It is strongly recommended that limits of personal care and personal and professional boundaries policies be written and implemented. The Company complaint policy should ensure that it indicates that the Commission can be contacted at any stage in the process. As planned, consideration should be given to providing a phone which can be used in private. H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 24 Southlands Southlands H56-H06 S23871 Southlands V236836 030805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent 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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