Inspection on 25/04/05 for St Leonards Place

This inspection was carried out on 25th April 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Leonards Place 26/09/06

St Leonards Place 04/10/05

St Leonards Place 08/02/05

St Leonards Place 01/11/04

St Leonards Place 02/12/03

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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 St. Leonards Place 96 Maidstone Road Chatham Kent ME4 6DG Lead Inspector Lucy Ansell Unannounced 25 April 2005 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. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St. Leonards Place Address 96 Maidstone Road Chatham Kent ME4 6DG 01634 831715 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) Mr. Russell Martin Care Home 3 Category(ies) of Learning Disabilities registration, with number of places St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8 February 2005 Brief Description of the Service: St Leonard’s Place is a specialist residential service, offering 24-hour care and individual support to three service users with learning disabilities and challenging behaviour. The home also offers a day care facility to one client this was not inspected. It has a staff team of eight, led by the owner/manager Russell Martin. The Home is a large Victorian house providing 3 purpose built flats for individual living. The accommodation is spread over three floors and a basement flat with the communal areas on the top floor. There are stairs to all floors. The home is situated in a residential area less than a mile from Chatham town centre. The home is located on a main bus route and within walking distance of shops and a Post Office. The home has front parking and attractive back garden. The home has its own transport. The owner Mr Martin has owned the home for over ten years, the experienced staff team have been in post for that period of time and so have the residents. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection under the terms of the Care Standards Act 2000 carried out by one inspector who was in the home from 09.00 to 12.30 on the 25th April 2005. During the inspection the owner/manager represented the home. Documentation and records were read, including care plans. A tour of the premises was undertaken. The inspectors spent time talking with 1 resident and observing other residents who are unable to communicate verbally, to ensure standards are being met and a good quality of life is being enjoyed by the residents. What the service does well: What has improved since the last inspection? The manager has a good understanding of the areas in which the home needs to constantly review to keep up with good practice. Planning was in place and evidence was seen that improvements and change needed from any requirements are implemented immediately by the home. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 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 St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 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) 1-5 Residents and their relatives are given the required information they need in the home’s Statement of Purpose and Service User guide to enable them to make an informed decision about moving into the home. The home’s system of pre assessment enables staff to assess the needs of residents satisfactorily and assure that their needs will be met at the home. EVIDENCE: The home has added the complaints procedure to its statement of purpose and service users guide. It is now clear and concise with all relevant information included. Residents are provided with a statement of terms and conditions when moving into the home. Evidence was seen of the homes contract in the care plans, which were very detailed. Residents are admitted following a full assessment by the homes manager, however all the residents have been with the home at least eight years. The newest admission last year was known though the day care service. The manager was able to explain the pre-assessment process and how it was staged over six weeks. This included assessment, trial visits, and staff exchanges to get to really know the client and see if they matched and the service could meet their needs. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 9 St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 Residents benefit from the home’s high standard of Care plans which encompass each resident’s health, personal and social care needs. Residents are treated with respect and dignity and their independence is promoted. EVIDENCE: Two residents care plans were looked at. These are very detailed documents that contained, risk assessments; individual plans for daily living, weekly plans and health needs. It also included good contact information and visits with family and friends. It was evident through reading the plans and discussion with the manager and service users that these were drawn up in joint agreement. The resident’s reviews are person centre and formatted to suit the individual’s personal wishes and capabilities. The Manager stated that a key worker system is in place in the home and weekly meetings are held between the key worker and the service user to discuss the plan. There was clear evidence of multi-agency reviews taking place and long and short-term goals being set. The home has also set up an ethical committee for St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 11 each resident with their own interested parties like resident, parents, social worker, key worker and manager who will meet to take joint decisions on any care needs. The care plans viewed included information about the preferred life style of the individual service users. There were detailed descriptions of guidance on how to care for the resident, and clear evidence of making informed decisions. Where service users rights to make decisions are limited, the home has recorded reasons on the care plans and in risk assessments. A service user spoken to during the inspection spoke of an environment in which they are encouraged and enabled to make decisions. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11-17 Resident’s opportunities for personal development are good in this home with ample chances to maintain and develop independent living skills. The home facilitates appropriate leisure enabling residents to maintain appropriate and fulfilling lifestyles. Links with the community are good and support and enrich resident’s social and educational opportunities. EVIDENCE: The care plans and daily recordings as well as direct observations made during this visit, continue to clearly evidence that residents are encouraged to learn, maintain and develop practical life skills to the best of their abilities. One resident is employed on a training scheme 4 days per week and also maintains the garden of the local children’s nursery at the weekends. One resident spoken with was not employed, but was supported by staff to undertake a range of activities within the home, as well as shopping, walking into town for breakfast and going to the cinema. It was apparent through discussion with service users that they had control over the activities they did St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 13 or did not participate in. The staff offered guidance if it was in their best interest and persuasion but the choice was theirs. The residents access the local community to do their shopping, collect their benefit money, and use the cinema, pubs and restaurants. Residents go out to activities independently based on an individual risk assessment. One service user regularly uses the local buses into town. Evidence was seen in the care plans of a range of leisure activities that they choose to participate in. The manager explained that they have friends to visit when they wish and can have overnight guests. As residents each have their own flats they can receive visitors in private. Residents each have their own flat for which they are responsible. Staff provide support only as agreed with the individual or where assessed and agreed in the care plan. A resident spoken with stated that they are supported to carry out there weekly shopping and that they prepare their own meals. The Manager stated that staff offers guidance to ensure that service users plan a nutritious menu for themselves. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 14 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 Residents’ enjoy living in an environment in which their privacy dignity and independence is promoted and protected. The health needs of residents are well met through good multi-disciplinary teamwork occurring on a regular basis. EVIDENCE: It was evident from speaking to the manager and looking through the documentation that they are very aware of the needs of their residents. The manager indicated that all support offered was aimed to maximise the resident’s independence. The manager described how routines of the home were flexible to suit the needs and wishes of the residents; this was backed up by the documentation. Two of the residents are very independent with their personal care needs so are offered guidance and supervision, and the other resident who needs more assistance, is offered this in as sensitively way as possible. The care plans were specific in detailing exactly how residents preferred personal support tasks were to be done. They also detail timings and preferred choices, and where guidance and direct support is required. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 15 The home promotes and maintains residents health through supporting and facilitating medical appointments as required. The Manager stated that all service users are registered with a GP of their choice. Care plans showed that continence management plans are place for one service user who requires the use of incontinence aids. The staffs on duty were observed indirectly throughout the inspection, they were seen to interact in a positive and respectful manner with residents. One resident gave positive feedback during the inspection about the approach of the staff team, commenting, “They are very kind”. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 16 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 Residents are knowledgeable of the home’s clear complaints procedure and residents and relatives are aware of how to complain and feel that their views are listened to and acted upon. EVIDENCE: The home has a clear step-by-step procedure that meets the requirement of the regulations. The complaints procedure was displayed within the home and evidence was seen of it included in the statement of purpose and service user guide. The home has received no complaints since the last inspection; evidence was seen of a copy of the complaints form. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 17 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) 24-30 Residents benefit from living in a safe, well-maintained and clean environment which offers privacy and comfort. EVIDENCE: The homes location and layout is suitable for its stated purpose; it provides a specialist service, within the individuals own flats, to service users with challenging behaviours. The home was decorated and furnished to a high standard and all the residents’ flats were personalised to their own tastes. The home has one lounge and office space across the top floor of the building. All of the flats have a lounge and kitchen with a separate bedroom, and bathroom/toilet. One flat had a second bedroom that was used for the staff “sleep in”. The home has sufficient toilet and bathroom facilities for the number of service users. The rooms were all clean and well decorated. Bedrooms have sufficient space to accommodate the required furniture. Residents are supported to buy different furniture if they wished. Most of the residents had chosen the décor for their own flat. The home has very high standards of cleanliness and no odours were detected anywhere in St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 18 the house. Laundry facilities were sited within each person’s kitchen, this was appropriate for the style of service as domestic in nature. Residents are encouraged to manage their own flats in line with ordinary living principles. The home had an infection control policy. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 19 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) 37,38,39 and 42 EVIDENCE: Not Assessed St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 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, 38,39 and 42 The residents benefit from having a manager who provides clear leadership and from an able staff team who offer a good quality of care to the residents. The home was unable to evidence that residents are adequately consulted. Whilst it is acknowledged that the home has competent staff there is a need for them to continue to develop their knowledge and skills so as to ensure the best possible care practice is offered all residents. EVIDENCE: The Manager has achieved the NVQ 4 in Management and has just completed the NVQ 4 in care. It was evident through discussion with the Manager and service users that the home has an open and transparent management structure. Evidence showed the Manager and staff being approachable. The Manager stated the home holds 6 monthly review meetings for all the service users. All service users are invited to attend the team meetings. No formal system for auditing the home annually is in place at St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 21 present. A requirement had been made that the home produces a questionnaire to gain feedback from stakeholders and other agencies; this is still ongoing and hopes to be in place soon. The risk assessments required in relation to windows on the first and second floors have been completed along with a bar being fitted. Some training is required for staff including medication, food hygiene and fire training this is almost completed and the home now has a matrix for easy showing. Records of fire system tests, Gas safety certificate and wiring tests were seen. Testing of portable electrical equipment by an appropriately qualified electrician has been completed. St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 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 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St. Leonards Place Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations St. Leonards Place H56-H06 S29027 St Leonards Place V223877 250406 Stage 4.doc Version 1.30 Page 24 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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