Inspection on 09/01/06 for St Johns Cottage

This inspection was carried out on 9th January 2006.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Johns Cottage 24/09/06

St Johns Cottage 21/06/05

St Johns Cottage 19/01/05

St Johns Cottage 18/06/04

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 St Johns Cottage Hospital Road Sevenoaks Kent TN13 3PH Lead Inspector Ruth Burnham Unannounced Inspection 9th January 2006 09:30 St Johns Cottage DS0000024019.V269146.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 St Johns Cottage DS0000024019.V269146.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. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Johns Cottage Address Hospital Road Sevenoaks Kent TN13 3PH 01732 457800 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) www.care-ltd.co.uk CARE (Cottage and Rural Enterprises Ltd) Mrs Karen Louise Meeson Care Home 8 Category(ies) of Learning disability (8) registration, with number of places St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2005 Brief Description of the Service: St Johns cottage occupies detached premises which were formerly 3 cottages which have been sympathetically converted to provide accommodation for 8 people with a learning disability. The accommodation is arranged on 2 floors, there is no passenger lift. One bedroom is on the ground floor. The registered manager is responsible for the day to day running of the home. Full time and part time care staff are employed who work a rota which includes one member of staff on sleep in duty at night. The home is located within walking distance of shops and other amenities. The town centre is also within walking distance or a short bus ride away. There is a small garden to the rear of the property. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by one inspector who found that many of the national minimum standards had been met or partially met and that the overall quality of care was good. Part of the premises and some records were examined. The inspector was able to talk to all the service users, 2 members of staff and the manager. Relationships observed during this and previous inspections between staff and service users demonstrated awareness of good practice. The environment is furnished and decorated to a reasonable standard. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People who may consider moving into the home in the future have clear information upon which to base a judgement and can be confident that their needs will be met. EVIDENCE: The people who live in this home are secure in the expectation that this will be their home for as long as they wish to remain, it is therefore very rare for new residents to move in however there is clear information within the statement of purpose and service user guide upon which prospective service users can make a decision whether this would be the right home for them and would meet their needs. There have been no new service users admitted to the home however, residents’ individual needs and aspirations are reviewed in detail annually to ensure that the support provided continues to be at an appropriate level. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 8 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): 8 People who live in the home are consulted and supported to run the home in the way in which they choose. EVIDENCE: People who live in the home are consulted and take part in all aspects of running the home, service users explained how they take part in residents meetings on a regular basis and one resident had recently enjoyed being involved in the national conference where they had had input into policy making. It is evident that this is very much the home of the people who live their with staff providing some support and guidance to enable residents to live life to the full and become as independent as possible. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 9 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): These standards were not examined during this inspection and therefore no judgement has been made, all standards were met at the last inspection. EVIDENCE: St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 10 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 - 21 People who live in the home can be confident that their healthcare and personal needs will be met. EVIDENCE: People who live in the home can be confident that any personal support takes account of their individual preferences; home routines are flexible and relevant and are agreed with residents. People who need additional specialist support are supported to access this where necessary and residents benefit from the consistency which is ensured through designated key workers, they were full of praise for the way staff support them and it was clear during the inspection that maximum opportunity is available for residents to exercise personal choice in all areas of their lives. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 11 People who live in the home benefit from the discreet and sensitive support which is given to enable them to manage their healthcare needs, records seen indicate that health is regularly monitored and prompt referrals made. Staff provide support with medication within a risk management framework to ensure the safety and welfare of residents, consent to medication is obtained and recorded and medicines are handled in accordance with recognised guidelines and legislation. There may be some risk of harm where not all staff who handle drugs have received accredited training on the safe handling of medication. People who live in the home benefit from the security of knowing that this is their home for as long as they choose to remain and their needs can continue to be met. Wishes in relation to death are recorded within individual care plans and some staff have received training in bereavement and loss. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 12 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): People who live in the home are listened to and protected from abuse. EVIDENCE: People who live in the home feel free to offer comment or complaint and are very clear about who to complain to, there is a very clear complaints procedure in a format which is accessible to service users. Residents are protected through robust adult protection procedures, it was encouraging to find that the skill and commitment of staff and input from specialist services has resolved the tension in the home which had formerly been a problem between two service users. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 13 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): The quality of life for people who live in the home is enhanced by the pleasant and homely environment however, there may be some risk where repairs are not carried out promptly. EVIDENCE: People who live in the home benefit from access to ample communal space with a choice of seating areas and a separate dining area, the premises are comfortable bright and cheerful and furnished and decorated to a reasonable standard providing a homely atmosphere. Residents were pleased to show the inspector around the home, all room sizes meet the requirements of the minimum standards and all residents enjoy the privacy of single rooms. Although not all of the facilities listed in the standard which relates to bedrooms are available and rooms are not all large enough to accommodate tables and additional chairs residents confirmed that they have been consulted on this issue and that they have chosen their own furnishings. Bedroom doors are fitted with suitable locks to protect residents’ privacy, staff would only override these in an emergency. One resident’s room has en-suite facilities and there are ample numbers of bathrooms/shower rooms to meet the needs of all the people who live in the home. Residents benefit from access to a small garden, a well equipped laundry and a private visitor’s room, the home has a no smoking policy which has been St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 14 agreed by all the people who live in the home. Staff are provided with adequate facilities for changing, showering and sleeping in. People who live in the home have a choice of lounge areas in addition to the spacious kitchen/diner, the kitchen floor is lifting at the join and needs repair or replacement to ensure that adequate standards of hygiene can be maintained for the protection of residents. None of the people in this home have physical disabilities, which require specialist equipment or installations. The laundry is well equipped and facilities are sited so that residents are protected form risk of infection in that soiled articles etc are not carried through food areas, .facilities for washing hands are available in the laundry and there are clear procedures for handling contaminated linen etc. Laundry floor finishes are impermeable and all surfaces are readily cleanable, the home was clean throughout at the time of the inspection. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 15 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 - 36 People who live in the home benefit from the support of a committed and well trained and supervised staff team. EVIDENCE: People who live in the home are supported by a caring staff team who know and support the main aims and values of the home, understand and implement the policies and procedures and have clear job descriptions. The inspector observed and residents confirmed that staff have good relationships with service users and are able to meet individual needs taking account of background and interests, staff are familiar with the General Social Care Council code of conduct and the standards of conduct and practice established by the regulatory bodies. People who live in the home have the respect of staff who are accessible to, approachable by and comfortable with service users. Staff have the necessary skills such as knowledge of the disabilities and specific conditions of service users, to meet individual needs including communication and dealing with anticipated behaviours. Residents benefit from the support of staff who have an appreciation of and an ability to balance the individual need and common needs. they are able to establish professional relationships with GPs, therapists, care managers etc. The numbers and skills mix of staff on duty ensure that uninterrupted work is carried on with individuals. Administration, organisation and communication is carried out effectively as is the day to day running of the home and the St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 16 management of emergencies. Regular staff meetings take place which are recorded and actioned. There are staff on duty at all times who can communicate with residents and staffing levels are regularly reviewed to reflect changing needs. People who live in the home are protected through sound recruitment procedures which include the take up of 2 written references prior to appointment and any gaps in employment records are explained. It was good to hear that one service user had been included on the interview panel for one of the staff on duty on the evening of the inspection. New staff are confirmed in place only after completion of a satisfactory CRB check and all staff receive statements of terms and conditions. The best interests of residents is served through good staff training and supervision in that the Provider has a training and development plan and dedicated training budget with a designated responsible person for training and development. Staff confirmed that they had structured induction training within 6 weeks and foundation training within 6 months. All staff receive equal opportunities training including disability and racial issues. Staff have an individual training and development assessment and at least 5 training days each year. Training and development is linked to service aims, users needs and individual service plans. There are established arrangements for managers to brief staff and to receive direct feedbackand staff who supervise are trained and supervised by senior staff. Staff confirmed that they have regular supervision meetings every month in addition to regular day to day contact. Staff meetings are also held monthlyand all staff have an annual appraisal to review performance and agree development plans. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 17 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 - 43 The safety and security of people who live in the home is promoted through safe working and sound management practice. EVIDENCE: People who live in the home benefit from the commitment and enthusiasm o f the registered manager who is undertaking the Registered Managers Award and the outcomes in the home indicate that the manager communicates a clear sense of direction and leadership and has strategies for enabling staff, residents and others to voice concerns and affect change. Management processes are open and transparant and both service users and staff praised the registered manager for her commitment and support. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 18 Managemnt practice gives priority to the best interests of residents , there is an annual development plan for the home. There is continuous self monitoring using a monthly audit however current quality assurance systms have not been developed to provide regular quality assurance reports in ine with Regulatio 24. Policies and procedures and practices are reviewed regularly in light of changes in legislation and professional advice and people who live in the home were represented by one resident at the national conference last year. Residents have acesss to their records and information which is held about them in the home and individual records and home records are secure, up to date and in good order and are maintained in accordance with the Data Protection Act and other statutory requirements. People who live in the home are protected through safe working practices including the training of staff in moving and handling, fire safety, first aid. Food hygeine, infection control and health and safety. The manager ensures compliance with relevent legislation and provides a written health and safety policy, environmenta risk assessments are carried out and that significant findings are recorded. The security of people who live in the home is safeguarded through sound financial management, the provider has a business and financial plan and systems are in place to ensure financial planning monitoring and control. The manager confirmed that insurance cover is in place to cover all eventualities to an adequate level and lines of accountability within the home and with external management are clearly understood. St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 19 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 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x 3 x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 2 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 3 2 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Johns Cottage Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 3 3 DS0000024019.V269146.R01.S.doc Version 5.0 Page 20 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. 2 Standard YA20 YA30 Regulation 18(1) 13(4) Requirement Timescale for action 28/02/06 3 YA39 24 Evidence of competence of staff in relation to medication training shall be available in the home. The registered person shall make 28/02/06 arrangements repairs to be carried out on the kitchen floor to prevent risk of harm A quality assurance report shall 28/02/06 be provided to the Commission RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 21 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. Extracts may not be used or reproduced without the express permission of CSCI St Johns Cottage DS0000024019.V269146.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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