Inspection on 21/11/06 for Summerlands

This inspection was carried out on 21st November 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 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

Summerlands 20/11/08

Summerlands 13/01/06

Summerlands 27/06/05

Summerlands 25/01/05

Summerlands 13/04/04

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 Summerlands Westwell Leacon Ashford Road Charing Ashford Kent TN27 0EE Lead Inspector Sue Gaskell Key Unannounced Inspection 21st November 2006 09:30 Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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 Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Summerlands Address Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Westwell Leacon Ashford Road Charing Ashford Kent TN27 0EE 01233 713454 Counticare Limited Post Vacant Care Home 9 Category(ies) of Learning disability (9), Mental disorder, registration, with number excluding learning disability or dementia (1) of places Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Services users with a Physical Disability are restricted to six (6). Service users with Mental Health diagnosis to be restricted to one (1) whose DOB is 29/04/1969. 13th January 2006 Date of last inspection Brief Description of the Service: Summerlands is registered to provide 24 hour accommodation, personal care and support for up to 9 adults with learning disabilities. The fees range from £1000 - £1690. The home is a modern detached property situated by a busy man road in a rural location on the outskirts of Ashford. There are 4 acres of well-maintained grounds incorporating a large lake that, with prior agreement, may be used by the public. Residents have unrestricted use of a secure garden area with large patio, and assisted use of the lake area. To the front of the property is a large tarmac area for parking. There is a small detached day unit with snoozelem sited close to the main house. Service users accommodation is on two levels. The ground floor consists of four en suite bedrooms that are wheelchair accessible, a large lounge, dining room, kitchen, laundry and sunroom. There is access to the patio area from the lounge. To the first floor there are three bedrooms and the managers office. There is also a room that is currently being used as a sleep in room. Access to the first floor is by stairs, Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 21st November 2006 between 09.30 and 13.30. The home currently has no registered manager but the acting manager is applying for registration. There were 9 people living at the home, and there are no vacancies. The inspector spoke to 3 residents, 1 resident’s Care Manager, and 4 members of staff. Some residents have limited communication and therefore the inspector observed residents for some time in order to see whether they appeared relaxed and comfortable. The Inspector toured the building and looked at all communal areas. 4 residents showed the Inspector their bedrooms. The inspection process also consisted of information collected before and during the visit to the home, and feedback from a local Care Manager after the site visit finished. Other information seen included general assessments, risk assessments and care plans, medication records, the duty rota and staff recruitment and supervision records. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. What the service does well: The home prepares clear and comprehensive care plans, which assists staff in providing consistent and appropriate care. The food is varied, nutritious and well presented. Staff are well trained and well supported. The home provides a well furnished and decorated, safe, clean environment. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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 Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose, service user guide and individual statement of terms and conditions, clearly says what service will be offered. Prospective residents can be confident that their needs will be assessed and can be met. EVIDENCE: There has been one admission to the home since the last inspection visit. That person’s file contained a detailed and comprehensive pre-admission assessment. The resident made several visits to the home prior to moving in. The home does not take emergency admissions. All residents have been issued with a service user guide and part of this is in a pictorial format. Residents are also issued with individual agreements stating their terms and conditions of residence. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans are easy to use and descriptive. Residents’ choices are respected and their decision-making is well supported. Residents are supported in taking risks in the daily and social activities that form part of an independent lifestyle. EVIDENCE: All residents have a care plan and 4 were examined in detail. The recording has generally improved, with more detail on goals and guidelines. The files also include personal profiles, assessments, likes and dislikes, and guidelines on Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 Page 10 how the home will assist residents in achieving their short and longer term goals. Residents have key workers who monitor their individual needs and activities and help them understand, and contribute as much as possible to, the contents of their care plans. Comprehensive risk assessments have been prepared for each resident’s needs or activities, and include specific guidelines on how to minimise any risk. The records showed that staff sign to acknowledge having read these guidelines. The inspector was informed that the home maintains a level of three staff per shift plus the manager or team leader during the day. Staff said that extra staffing has always provided if there is a necessity. Issues relating to confidentiality are addressed during the induction period. All records are stored in a lockable office and there was no public display of confidential or personal information. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily life meets the residents’ lifestyle preferences and expectations. Residents have regular contact with their families and friends. Residents receive a nourishing and balanced diet. EVIDENCE: The residents are supported by the staff and manager to help them participate in a range of activities for educational, recreational and therapeutic purposes. There is a weekly programme of activities but the home has to be flexible if Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 Page 12 residents’ needs change or if they would rather do something else. An example of this is that residents generally attend a day centre run by the same company generally twice a week. On the day of the inspection one resident did not wish to go and remained in the house. A member of staff said that residents’ activities include bowling, swimming, horse riding and going to clubs and discos. The care plans contain a list of residents’ needs, likes and dislikes and preferences, and some of this is in pictorial form. Residents may come and go as they please in the communal areas and grounds, subject to risk assessments. The manager said that this is risk assessed on a continuous basis as residents’ needs change. There was evidence in the residents’ daily records to show that families, and other visitors are encouraged and welcomed. One resident said that he was going home soon to see his family and another resident was seeing his sister that day. Most of the residents have their finances managed by the company with monies listed individually in a combined dedicated account. The Inspector saw the statements showing individual transactions that are provided to the home for monitoring. Records and receipts are kept for the monies held in personal wallets and individual tins. Staff signatures are required for monies taken out when residents spend money on social activities such as going to the pub. The manager said that records are audited as part of Regulation 26 visits. Meals are provided mainly based on residents’ choices, but also taking into account the need for a reasonably balanced diet. One resident has a particular need which requires special consideration and the records showed that he has been referred to a consultant. The store cupboard contained a wide range of good quality food including fresh fruit and vegetables. Residents said that they enjoy accompanying staff in shopping for provisions and one resident said that he was going Christmas shopping with staff. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ choices over their care are respected. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. EVIDENCE: All of the residents who were either spoken to or present during the inspection were seen to be relaxed and comfortable interacting with staff. Staff explained how residents are supported as their needs change, and referred to the importance of being sensitive to the needs of each individual. The acting manager said that he had been concerned that a delay in sourcing training in Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 Page 14 the use of “makaton” communication was affecting one resident, but this training has now been arranged. Residents’ care plans and daily records referred to clear guidelines on providing support and monitoring health care and social care needs. There was evidence in residents’ files to show that residents’ needs have been closely monitored and that they have been referred for specialist help whenever necessary. One resident’s Care Manager confirmed that staff have been quick to respond to his needs and supportive when he has required treatment. The two members of staff spoken to showed a high level of awareness of residents’ needs and referred to various issues, such as medical, nutritional or communication assessments, being included in the care plans. There was evidence of staff involvement in the daily recording, care plans and referrals for specialist help. The acting manager said that new members of staff are referred to care plans as a matter of priority and staff have to sign to acknowledge having read any important guidelines. The home has sound medication procedures. Staff confirmed that only trained staff would administer medication and that all staff have to read the procedures stored in the medication file. Medication was stored securely and appropriately and there are procedures for its receipt and disposal. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident their complaints will be listened to and dealt with appropriately and that they will be protected from abuse. EVIDENCE: Although it was difficult to obtain information from some of the residents due to their communication needs, one resident said that he would feel comfortable telling staff about anything he was not happy with. Staff said that every effort is made to ensure that residents can communicate their feelings if they are not happy with something. The home uses complaints forms that have been produced in a pictorial format. The home has adult abuse procedures in place and staff confirmed that they have received training in adult protection awareness and when and how to intervene in order to safeguard and assist residents. The staff induction process includes information for staff on policies and procedures concerning appropriate behaviour when assisting with personal care, the use of appropriate intervention techniques, and “whistle blowing”. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a homely,comfortable and safe environment. The home is hygienic and clean. EVIDENCE: All bedrooms and living areas are furnished and decorated to a good standard, and contained the type of furniture and equipment necessary to provide a homely environment. 2 residents said that they are pleased with their bedrooms and that they had helped to choose colours, furniture etc. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 Page 17 The upper floor of the home has areas with sloping ceilings. Part of the landing area, which leads to two bedrooms and the bathroom, has a height less than 6 foot but has been risk assessed for safe use. Residents have single rooms where they can display their own possessions such as posters and models, and have their own TV, DVD player etc. One resident has a ground floor bedroom as he isn’t confident in using stairs. All four ground floor bedrooms have enough room for wheelchairs. Although the acting manager acknowledged that there has been a problem with one resident’s room, and that new flooring has been ordered, all areas were seen to be clean and hygienic. There is an alarm call system and one resident’s Care Manager confirmed that staff have asked the resident to make use of this. There is a well-maintained garden and patio with garden furniture that is used by the residents. There is a large lake in the grounds and fencing has been put up around the perimeter of the lake as a safety precaution. Since members of the public are sometimes allowed access to the lake, risk assessments have been carried out for that and the public use a separate gate. Staff showed a good awareness of health and safety issues. There is separate laundry area that has dual access from the ground floor hallway and the general office next to the kitchen. Residents may assist in the laundry with staff support. There is a commercial washer and a drier in the laundry with a domestic washing machine in the general office. Disposable hand drying towels and pump soap dispensers reduce the risk of cross infection. Maintenance certificates were current and there are no outstanding health and safety requirements. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 & 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staffing, in terms of both numbers and competency, is appropriate to the current needs of the residents. Residents are protected by the Home’s sound recruitment procedures. Staff are well trained and supported and morale is high. EVIDENCE: The acting manager said that the current staff rota includes the manager or a shift leader and generally 3 support staff. Another member of staff said that this is adequate to ensure that residents are safe and can participate in their chosen activities. Night staffing also appears adequate. There are emergency on call systems as well as methods of internal communication systems. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 Page 19 The staff files included CRB checks on all staff, references and evidence of verbal references. The manager explained that where there had been a delay in obtaining a CRB check this was because the staff member, who had already obtained CRB clearance within the company, had transferred from being a “bank” staff to a permanent member of staff. The files also included evidence of induction training, further training and regular recorded supervision. The manager said that over 50 of staff already have NVQ 2 or 3 and that there are 3 staff currently working on their NVQ3. Training since the last inspection includes “SKIP” training to manager challenging behaviour, Adult Protection awareness, Basic Food Hygiene, Diabetes awareness, Fire Safety and the administering of special medication for epilepsy. Staff referred to the high level of morale in the home with good support for work and any personal issues that may affect their work. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run in a manner that encourages the development of clients. There are regular quality assurance and safety checks to ensure that the home is run in the best interests of the clients and their safety and welfare is protected and promoted. All areas are clean, hygienic and well maintained. EVIDENCE: Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 Page 21 Although currently there is no registered manager in place, the acting manager is in the process of applying for registration. He has many years experience in working with adults with learning disabilities, and appeared knowledgeable and competent. Quality assurance is carried out through the Regulation 26 visits and also through the Company’s internal audit system. Staff said that residents’ views and feelings are regularly questioned and monitored, either through talking to them or through observing them to see whether or not they appear happy. This is particularly important where some residents’ needs have changed. Staff said that quality assurance is given a high priority and any feedback from residents and/or their families or advocates is acted upon. One resident’s Care Manager confirmed this. The general management of the home and completion of records are of generally of a good standard. One member of staff said that morale in the home is very good and that the manager is supportive. There were no obvious safety hazards around the home and there was evidence to show that health and safety issues are taken seriously eg staff ensuring that the laundry is locked and that cleaning chemicals are locked away. Environmental risk assessments have been carried out, including use of the lake and access to the lake by the public. There is security lighting around the outside of the home. A member of staff has responsibility for routine testing of equipment and ensures that regular weekly tests are carried out and recorded. All staff have had recent fire safety training and the regular fire drills also include residents. The maintenance file also contained current certificates to show that regular checks eg gas, electricity, are carried out. Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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. 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. Refer to Standard Good Practice Recommendations Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Summerlands DS0000023592.V319638.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!