Inspection on 23/08/05 for Swerford House

This inspection was carried out on 23rd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Swerford House 22/03/07

Swerford House 24/02/06

Similar services:

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Insight - Eastchurch

Southfields

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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 Swerford House The Avenue Temple Ewell, Kent CT16 3AW Lead Inspector Julie Sumner Announced 23/08/05 at 10:00am 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. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Swerford House Address The Avenue, Temple Ewell Kent CT16 3AW 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) 01304 821432 01304 821432 swerford@hqls.org.uk High Quality Lifestyles Limited Mr Michael Harrison Registered Care Home 5 Category(ies) of Learning Disability registration, with number of places Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection n/a Brief Description of the Service: Swerford is a home for people with learning disabilities and communication difficulties who present challenging behaviour at times. The home is owned by the private company: High Quality Lifestyles. The companys philosophy is to support people who have displayed behaviour that has caused them and others difficulty and has limited ordinary/usual kinds of life opportunities by positive guidance and a specialised environment. Swerford is registered to provide accommodation for up to 5 people. The home is a detached property set in spacious grounds on a hill in Temple Ewell, a village mid way between Dover and Folkestone. It is a semi rural area and the home provides transport to ensure the service users are able to access facilities in Dover or Folkestone and pursue a variety of activities. The local bus route is on the main road just down the road from the home. The bedrooms are single and are decorated to suit individual needs and preferences. Communal rooms are light and spacious. The home is decorated and furnished to suit the individuals living in the home. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first routine inspection for the home since it has opened. The inspection was announced and started at 10am and lasted throughout the day. Service users were participating in their usual activities and joined in with the inspection here and there. Questionnaires were given out to relatives and visiting professionals to get their viewpoint on the home. All feedback received was positive. Swerford is a newly acquired home and has been furnished and decorated just prior to everyone moving in. The home was clean and everything was in good condition. Some furniture has been specially made or adapted for individuals. Staff have spent time getting to know service users and helping them settle into their new home. The following methods of inspection and information gathering were used: observing activity in the home, spending time with service users and staff, including having lunch, some one-to-one discussion and group discussion at different times with staff and some interaction with service users, touring the home and reading and discussing policies, plans and records including individual service user plans, medication charts, some staff records including training records and duty rota. What the service does well: Staff give service users lots of positive attention and support individuals with different activities. Service users are guided to go out shopping, pursue sport and leisure activities. New experiences are introduced gradually, a bit at a time, out in the community depending on each person’s ability to cope and what they like to do. There are support strategies and diversion techniques to develop methods of communication and social skills as an alternative to challenging behaviour. Plans for support are written to make sure all staff know how each person needs to be guided and what they like to do. Service users receive constructive support from staff to guide behaviour and develop social and communication skills with good clearly written plans. Clear records are kept to discreetly measure progress and effectiveness of support in reducing socially limiting behaviour and increase opportunities. A requirement has been made in respect of this. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 6 Where it is indicated in the agreement between the home and the care managers for one or more members of staff to give individual support, this is given consistently. 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. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Assessments have been completed for all service users and give a good basis of current needs and abilities. EVIDENCE: Assessments are carried out prior to moving into the home and then reviewed in the home following monitoring of the persons’ wellbeing skill development and behaviour. Assessments are carried out in conjunction with the behaviour support team. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 7 9 Service users know that their views are listened to and that their personal goals are reflected in their individual plans and potential risks are managed. Service users receive good support to develop social skills and overcome communication difficulties. Service users are supported and encouraged to communicate their wishes. EVIDENCE: Service user plans are well designed with support strategies documented and clear guidelines for staff. Permission for support with behavioural strategies has been obtained from appropriate medical and psychology specialists. Support plans have been written for individuals with consideration to religious and cultural beliefs. Service user plans are reviewed every six months and more frequently if needs or circumstances change. Records are kept to monitor effectiveness of support and modify the guidelines for support as needed. There are plans and activity timetables that form the basis for the day but what actually happens is flexible and service user led to encourage individuals Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 10 to take control where they can. As individuals develop skills and confidence in a situation, the level of participation changes to reflect this. Video documentation is used as evidence to monitor progress with some activities. Risk assessments are in place for all relevant circumstances and have been designed to provide appropriate staff support when out in the community. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 13 15 16 17 Service users are able to go out with appropriate support and develop skills to cope with and enjoy different opportunities in the community. Service users are enabled to go on holiday if they wish. Service users are supported to go out and exercise to relieve tension and keep fit and healthy. Contact with service users’ families and friends is encouraged and supported. Service users are provided with a good range of meals and are able to choose where and when they want to eat. EVIDENCE: Service users are given the opportunity to participate in the tasks carried out as part of running the home on a gradual basis introducing experiences and assessing progress. One service user likes to help with the food shopping. One service user is being introduced to different shopping and activity experiences where there is minimal pressure and people. Activities are also introduced on an experimental basis to give individuals the opportunity to try Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 12 something new. A range of activities are participated in from walks in the local area to having a meal or drink in a café. One service user also likes swimming including in the sea. At present all service users go out individual with one-toone or one-to-two support. The home works together with service users’ families. Relationships with relatives are supported and encouraged. Service users are free to access all areas of the home and grounds, excluding other people’s bedrooms. Where there are identified risks, for example, in the kitchen these are assessed regarding any necessary limitations on access. Each service user is offered their own key to their bedroom so that they can lock it. Staff have overriding keys in case of emergency. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not inspected at this time. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 There is an effective complaints procedure but at present it is not accessible to service users. There is an effective financial procedure and systems to safeguard service users’ money. EVIDENCE: There is a complaints procedure. The home has had one complaint. Feedback from a visiting professional commented that “the complaint was dealt with in a very appropriate way”. The company is working on the development of a complaints procedure suitable for service users. The homes financial procedures were discussed and records viewed. Only the manager and one other member of staff hold keys to the safe where cash tins are kept. Each service user has a bank account with a passbook and additional records are kept of all transactions with two signatures when money is spent on behalf of individuals. Service users mostly have other representatives or family members as appointees. The manager keeps care managers informed regarding individuals’ accounts where there is no other external appointee. All procedures and money is audited by the company administrator and is included in the monitoring visits. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 15 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 Service users benefit from a functional and pleasant environment. EVIDENCE: The home was clean and well maintained. It is still new so there was still the newness to fixtures and fittings. The home has been designed to maximise space and light and provides a good environment with enough different areas for service users to move around and not always be together. All the furniture has been purchased to suit individual needs. Some furniture has been specially made including an extra sized bed and a leather suite with removable covers. All service users have their own bedroom and these have been decorated and furnished personally. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 35 Service users benefit from consistent support from the staff team and having the support of staff they already know in a new environment. Staff training would enhance the quality of support provided and provide staff with skills to further increase opportunities to service users. EVIDENCE: The staff team consists of a mixture of experienced care staff who have transferred from Wolverton Court and St. Michaels and new care staff. All staff were observed to interact well with each other and service users. Team leaders have identified areas of responsibility for tasks being completed and ongoing and everyone spoken to was clear in their role in the home. There are monthly staff meetings that are minuted. The shift pattern has been organised around the needs of service users. At the beginning of each shift the shift leader completes an activity planner including appointments, planned activities and taking changeable factors into account like the weather and how individuals are feeling. The manager holds the staffing budget and adjusts it accordingly. Length and time of shifts vary but are organised so that there are more staff around the times when service users go out and around planned activities. The staffing level is reviewed and rearranged if needs change. The home is expecting a new service user to Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 17 move in and additional night staff have been planned to accommodate and support him. The company has employed a training coordinator but there was no training plan available in the home. There was a print out of what training has been attended by staff with some booked courses and this was viewed. There were several gaps where training had not been provided. Several members of staff have only received induction training and training in the safe management of aggressive behaviour. A requirement has been made in respect of this. Some NVQ training is being provided. 3 staff are studying NVQ 2 and 2 shift leaders are studying NVQ 3. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 18 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) 38, 39, 42 Service users benefit from a well run home with a clear vision and direction to develop its service. A quality assurance monitoring system would ensure that the service being provided in the home is what service users want and is meeting their needs. The health and safety of service users and staff has not been ensured due to the lack of training provided in safe working practices. EVIDENCE: The registered manager has transferred from being manager of Wolverton Court, one of the other homes owned by the company, and has several years management experience. All staff were clear in their roles and worked confidently with service users. A shift log is completed at the end of each shift for continuity and for overall monitoring. If accidents or incidents occur these are included on the shift log but are also recorded using accident book and incidents are reported appropriately including regulation 37 notifications. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 19 At present there is no quality assurance audit system in place by the company. The only aspect of monitoring is by the company representative carrying out regulation 26 visits. The reports are informative and have been given to CSCI although they have not always been carried out monthly and service user participation is negligible. It was the company’s intention to set this up last year but due to unforeseen circumstances this process was halted. The company has employed a new member of staff and this will form part of their role. There are contracts for maintenance of the services and equipment to and in the home. The company also employs a maintenance person support the upkeep of the home. The electricity supply to the home has not been able to meet the demand. Arrangements have been made with the electricity company to increase the power supply. Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 20 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score 3 x x x 1 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Swerford House Score x x x x Standard No 37 38 39 40 41 42 43 Score x 3 1 x x 1 x H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 21 n/a 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 35, 42 Regulation 18 (1) (a) (c)(i)(ii) Requirement All staff must attend training to ensure safe working practices and ensure the health and welfare of service users. A training and development plan needs to be designed for all staff to include all mandatory and essential training to meet service users needs. Training plan to be provided to the CSCI by timescale. Unannounced visits by company representative to be carried out monthly and preferably by someone who is able to give service users with communication difficulties the opportunity to participate. To set up a quality assurance audit system within the company to measure success in achieving aims and statement of purpose of the home based on views of service users and their representatives. System structure and planned implementation to be completed by timescale. Timescale for action 30th November 2005 2. 39 26 30th November 2005 3. 39 24 (1) (a,b) (2) (3) 31st March 2006 Swerford House H56-H05 S62504 Swerford House V238493 230805 Stage 4.doc Version 1.40 Page 22 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 32, 37 Good Practice Recommendations To continue to work towards achieving NVQ targets including the manager to continue to work towards his NVQ level 4/RMA and relevant qualifications. 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