Inspection on 04/10/05 for St Leonards Place

This inspection was carried out on 4th October 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Leonards Place 26/09/06

St Leonards Place 25/04/05

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 Announced Inspection 4th October 2005 09:30 St Leonards Place DS0000029027.V279620.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 Leonards Place DS0000029027.V279620.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 Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 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 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) St Leonards Place Limited Mr Russell Peter Martin Care Home 3 Category(ies) of Learning disability (3) registration, with number of places St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 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 DS0000029027.V279620.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection at St Leonards Place took place on 4th October 2005 by one inspector Lucy Ansell. The Inspector agreed and explained the inspection process with the Registered Manager and discussed the ethos and values of the home. Time was spent reviewing a sample of written policies and procedures, looking at care plans and records kept within the home. A tour of premises and discussions with two residents were undertaken. The focus of the inspection was to assess St Leonards in accordance to the National Minimum Standards for Young Adults and principally on resident’s views of the home. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. Some Standards were not inspected in full and the last report should be read in conjunction to obtain a full picture. What the service does well: What has improved since the last inspection? The manager and his team have a better awareness of the focus of any training and ensure it is adequate and relevant for the team. The team feels it has gained from having staff that are motivated and committed having completed quality training. To stay current with the changes happening in the field of care the manager has joined the Medway work force development partnership. St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 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 DS0000029027.V279620.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 St Leonards Place DS0000029027.V279620.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): 1-5 Residents have enough information to make an informed decision about moving into the home, and are confident the home can meet their needs. EVIDENCE: The home’s Statement of Purpose and Service Users Guide had been reviewed and now contained the required information. It is clear and concise with all relevant information included. The home could consider working on making the service user guide into a pictorial format with easy reading so it is suitable for their residents. 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 owner; 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 DS0000029027.V279620.R01.S.doc Version 5.0 Page 9 St Leonards Place DS0000029027.V279620.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): 6,8,10 Residents can be confident that their individual needs and choices are well met by the plans of care. Residents can be confident that they will be consulted and participate in all aspect of life in the home. Residents benefit from information about them being handled appropriately and confidentiality maintained. EVIDENCE: The care plans were seen these hold only necessary information. These were very detailed documents that contained, risk assessments as required; individual plans for daily living, support plans and health needs. The monthly and six monthly reviews were all up to date and were kept filed in a separate filing cabinet. The home has also set up an ethical committee for 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. St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 Page 11 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 usually recorded reasons on the care plans and in risk assessments. The plan of care that was sampled did not demonstrate that risk assessments were in place as the resident is very independent however there does need to be put on file notification that risk assessments are not required. A service user spoken to during the inspection spoke of an environment in which they are encouraged and enabled to make decisions. He was offered support and guidance that enhanced his independence by staff working along side him promoting his rights. This was evidenced by the many activities he is able to undertake by himself like traveling on a train or coach to see friends, going out on social evenings with his own group of friends. The information held by the home is excellent and shows the staff have a complete knowledge and understanding of the residents needs. The home continues to be person centred in its practice and the residents are consulted on all decisions and participate fully in the home. The home has policies on confidentiality and the residents are aware of issues surrounding their own privacy. The home actively involves all residents in any decisions being made or new procedures being implemented. St Leonards Place DS0000029027.V279620.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): 11-17 Residents’ 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 or did not participate in. The staff offered guidance if it was in their best interest and persuasion but the choice was theirs. St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 Page 13 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 DS0000029027.V279620.R01.S.doc Version 5.0 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 the following standard(s): 19 and 20 Residents can be confident that their personal and health care needs will be well met. Residents are protected by the home’s medication policies and procedures. EVIDENCE: The health needs of residents are well met with evidence of good multidisciplinary working taking place on a regular basisThe 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. There was also clear evidence of medication reviews happening and optician and dentist appointments. The home’s policies and procedures on medication has improved its procedures around checking medication stocks and can now cross reference with the administration sheets. The medication administration sheets were seen these were all filled in correctly need to have a photo and known allergies on the sheet. The procedure for giving out PRN medication was good with space to put how many given and at what time. St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 Page 15 St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 Residents are protected from abuse and benefit from having access to a clear complaints procedure. EVIDENCE: The home has a clear step-by-step complaints procedure that meets the requirement of the regulations. The residents know the complaints procedure and were able to tell me quite clearly whom they would tell if they had any concerns, but the home has received no complaints since the last inspection. The home would be advised to produce a pictorial complaints procedure for all the residents to have in their room. The home is using the Kent and Medways new Adult protection policy as the homes guidelines. Staffs spoken to were clear on the procedures to follow and the manager is thinking of taking a course to enable him to teach the staff Adult Protection. The home will continue to send all staff to an outside agencies course on adult protection so they can have a wider view on the subject. St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 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 the following standard(s): 24 and 30 Residents benefit from living in a safe, well maintained, clean and homely environment in which the standard of décor, furnishings and fittings are high. EVIDENCE: The home’s 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 very high standards of cleanliness and no odours were detected anywhere in the house. The home tests the water for temperatures and Legionella, and thermostatic valves have been fitted. Laundry facilities were sited within all the kitchens, this was appropriate for the style of service as domestic in nature. Hand washing facilities are prominently sited with towels available. Policies and procedures are in place for infection control, disposal of clinical waste. Protective clothing is available if required. St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 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 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, 35 and 36 The residents benefit from being cared for by a staff team who are well supported and supervised. The residents will benefit from staff being well trained. EVIDENCE: All staff members have a job description. It was evident through discussion and observation, that they understand the aims of the home and are committed to achieving them. They are aware of their respective roles and how these support the goals set out in the service users’ plans. All staff have a copy of the General Social Care Councils Code of Practice. As already indicated there is close liaison with external support services including Consultant Psychiatrists, Psychologists, Community Psychiatric Nurses, GP’s and the Community Learning Disability Team. As already indicated there is an experienced and well-trained staff team who show clear evidence of commitment to the service and to identifying and meeting service users needs. In addition to the ongoing induction and foundation training programmes in which all staff participates, five staff members have successfully completed NVQ training level 2,3 and the manager has completed level 4. The standard will therefore be met in this regard. St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 Page 19 The home’s training programme runs from February to March and the manager is hopeful all mandatory fields of training will be completed. The home will also need to include Adult protection and challenging behaviour on to the list of required courses. The manager has tried to ensure that all training carried out by the staff team is relevant and worthwhile. All staff receive supervision and support in an informal as well as formally bimonthly. This includes: the homes aims and philosophy, work with individual clients, support and professional guidance and training and development needs. The manager keeps a record stored securely of all supervision and a date is made for the next one at the end of the session. St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 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 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): 37,38,41, 42 The residents benefit from a well run home with good transparent leadership and they can be confident that their views are listened to . The residents’ best interest and rights are safeguarded by the home’s policies and procedures. EVIDENCE: The manager is experienced and competent to run the home as has over 15 years experience with clients with learning difficulties. He has now completed the NVQ 4 and RMA and will hopefully have this by the end of the year. The owners need to ensure periodic training is undertaken to maintain and update his skills and knowledge. The residents benefit from the management approach of the home and an open and inclusive atmosphere is created. The processes of managing and St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 Page 21 running the home are open and transparent and the residents live very much as part of the family. The home does have a quality assurance and monitoring system in place and monthly surveys the residents. However the home has to produce the results and outcomes for all interested parties to see. This could be incorporated into the annual reviews. The home received six comments cards back from family and health and social care professionals all praising the service and care received. The home does have all the policies and procedures required, and yearly updates and reviews them. The policies seen all need to be dated with the reviews and signed. The records required by regulation for the protection of residents and for the effective and efficient running of the home are all maintained and up to date. The owners ensures as far as is possible the health safety and welfare of the residents. Their moving and handling training is up to date, they are current with fire safety equipment and procedures and testing. The home has safe storage for hazardous substances and COSHH sheets have been obtained. The home has fitted a valve to regulate the water temperatures, and risk assessments for the property have been carried out. The home is financially viable and finances are spent on improvements as are needed. Insurance cover for the home was seen. Lines of accountability are clear and well evidenced. St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 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 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x 3 x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 4 X X X X x 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 x x 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Leonards Place Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 4 x x 3 3 x DS0000029027.V279620.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? no 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 YA23 YA35 Regulation 23 A(1) 36 (2) To ensure training is To ensure behaviour Requirement all Adult protection completed for all staff. all challenging training up to date Timescale for action 30/03/06 30/03/06 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 2 Refer to Standard YA1 YA6 Good Practice Recommendations It is a good practice recommendation to make the service user guide into a pictorial format with easy reading so it is suitable for their residents. It is a good practice recommendation to ensure the plan of care has a current risk assessment for all needs. St Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 Page 24 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 Leonards Place DS0000029027.V279620.R01.S.doc Version 5.0 Page 25 - 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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