Inspection on 24/02/06 for Swerford House

This inspection was carried out on 24th February 2006.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Swerford House 22/03/07

Swerford House 23/08/05

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 Swerford House Swerford House The Avenue Temple Ewell Kent CT16 3AW Lead Inspector Julie Sumner Unannounced Inspection 24th February 2006 10:00 DS0000062504.V263382.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 DS0000062504.V263382.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. DS0000062504.V263382.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Swerford House Address Swerford House The Avenue Temple Ewell Kent CT16 3AW 01304 821432 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) High Quality Lifestyles Limited Mr Michael Harrison Care Home 5 Category(ies) of Learning disability (5) registration, with number of places DS0000062504.V263382.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. On vacation of bedroon 4 by service user whose date of birth is 09/09/1981 the sink facility shoud be reinstalled. 23rd August 2005 Date of last inspection Brief Description of the Service: Swerford House 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 guidence and a specialised environment. Swerford House 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. DS0000062504.V263382.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out during one day in February. Around six hours were spent in the home. All service users were in the house at the beginning of the inspection, just finishing getting ready for the day and being supported one-to-one by staff. The atmosphere was calm and the home was clean and homely. Service users participated in the inspection as much as they were able to. Most service users have limited communication skills. Some service users are able to speak and comments were made that directly related to what was happening to them rather than describing the home. These comments are therefore not quoted here but have been indirectly included in other parts of the report. The staff commented, “the home is well organised and well managed”, “there is a good team and we all get on and work together”. 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 continue to 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. These are currently being developed using a format that looks at wishes and support needs from an individual perspective and using pictures and language more easily understandable for people with learning disabilities. 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 discretely measure progress and effectiveness of support in reducing socially limiting behaviour and increase opportunities. DS0000062504.V263382.R01.S.doc Version 5.0 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. DS0000062504.V263382.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 DS0000062504.V263382.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): EVIDENCE: Not inspected at this time. DS0000062504.V263382.R01.S.doc Version 5.0 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 the following standard(s): 6 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. EVIDENCE: This group of standards was assessed more fully at the previous inspection. Care/support plans were viewed. The manager is currently working on some new service user profiles to add to the current care/support plans. These highlight what is actually important to each individual and uses pictures, colour and direct language so that they are designed to be accessible to people with learning disabilities. DS0000062504.V263382.R01.S.doc Version 5.0 Page 10 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): 13, 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 provided with a good range of meals and are able to choose where and when they want to eat. EVIDENCE: This group of standards was assessed more fully at the previous inspection. There is a timetable for planned activities for service users to choose from and this was viewed. Individuals have tried some new activities and these have become regular, including horse riding and bowling. Structures are in place to support individuals with behaviour that could be detrimental to them or others. The inspector had lunch with service users. There was a varied menu and the meal was balanced and appetising. Service users participate in some of the meal preparation and are guided depending on their understanding and current skills. There are good records kept of food provided and what is actually eaten by individuals. DS0000062504.V263382.R01.S.doc Version 5.0 Page 11 DS0000062504.V263382.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Service users’ preferences in how they are supported are taken into account. Service users are supported well with maintaining their health and managing individual health conditions. The systems for medication administration are good with clear and comprehensive arrangements being in place to ensure service users medication needs are met. EVIDENCE: Each service user has one-to-one support. Staff were observed supporting each individual in a different way depending on what support they needed and interaction observed was service user led. Guidelines for support are included in the service user plan of care. All service users are registered with a GP and go down to the surgery for arranged appointments with support of staff. There are health check update sheets which are completed for every incident related to individual health and kept in a folder for reference. A sample of health records were viewed and discussed. Records were also viewed where individuals have been assessed and given gradual experiences in preparation for a specific health investigation or treatment. DS0000062504.V263382.R01.S.doc Version 5.0 Page 13 The home uses a monitored dosage system. Medication administration, storage and records were viewed. All medication seen was stored and labelled correctly. Staff administering medication have attended medication training and this was also included on the training plan viewed. DS0000062504.V263382.R01.S.doc Version 5.0 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 the following standard(s): 22, 23 There is an effective complaints procedure and systems are being developed to make it more accessible to service users. There are effective procedures in place to protect service users from risk of abuse. EVIDENCE: This was inspected at the last inspection but parts of the process were discussed with the manager and records viewed. The emphasis has been on developing appropriate communication methods that suit individuals involved in the care or support of service users so that difficulties and disagreements can be resolved to each person’s satisfaction. Adult protection training is included on the training plan and more than half the team have attended. It is also included in the induction training for new staff. Staff were aware that there is an adult protection procedure and what constitutes abuse. As staff read the homes procedures they sign that they have read and understood. DS0000062504.V263382.R01.S.doc Version 5.0 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 the following standard(s): 30 The home was clean throughout. There is a good size laundry room with appropriate equipment to meet service users’ needs. EVIDENCE: A tour of the home was undertaken. The laundry was viewed and equipment and procedures discussed with the manager. DS0000062504.V263382.R01.S.doc Version 5.0 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 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): 34, 35, 36 A robust recruitment process is carried out to protect service users. Continuing to develop the range and type of training provided to staff will enhance their skills for supporting service users. Staff feel well supported. EVIDENCE: A sample of staff files were viewed with regard to recruitment checks carried out. There was evidence of CRB and POVA checks being carried out and references being obtained prior to employment. The company has employed a training coordinator and a training plan has been designed. The current training record was viewed. The staff rota was also viewed and indicated when staff were booked on training courses and shift cover to enable attendance without reducing the staff support in the home. The staff have attended courses arranged in the majority of mandatory subjects. There are some gaps, particularly in moving and handling and fire safety needs updating again. The current range of training focuses on the mandatory training courses, NVQ and training in techniques to support and manage behaviour which challenges. Staff have all attended a Makaton signing course and using this when communicating with service users has been encouraged. Staff were observed using makaton with individuals. DS0000062504.V263382.R01.S.doc Version 5.0 Page 17 NVQ training is being provided to meet the workforce target. 3 staff are studying NVQ 2 and 2 shift leaders are studying NVQ 3. Staff spoke positively about the training they had received so far. They said they felt supported by the management. They have received one-to-one supervision and regular staff meetings are held in the home to promote communication within the team. DS0000062504.V263382.R01.S.doc Version 5.0 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 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, 39, 42 Service users benefit from a well run home. There is a clear vision and clear direction to develop the service. Development of the quality assurance monitoring system would determine whether the service being provided in the home is what service users want and is meeting their needs. This would provide the basis for the development plan for the home. Continuing the health and safety training provided to staff will make the home and workplace safer. EVIDENCE: The registered manager has over two years experience in management and had commenced studying NVQ 4 but it has been put on hold for the time being. HQL has designed a training programme for the senior staff to provide them with specialist skills to support people who display challenging behaviour. The registered manager is currently studying the first year of this course. DS0000062504.V263382.R01.S.doc Version 5.0 Page 19 The company are developing the quality assurance system. Records written and kept in the home will feed into this system. Regulation 26 visits have been carried out monthly by a company representative who has direct experience working with people with learning disabilities and communication difficulties. Staff training records and the training plan were viewed. There has been significant progress since the last inspection in mandatory training provided and attended. Staff have received training in health and safety, manual handling, fire training, first aid, basic food hygiene and infection control. Not all staff have attended all courses and therefore the requirement to provide training for all staff has been carried over. Other training to protect service users and staff that has been identified by the company as essential including the diversion and management of challenging behaviour has been attended by all staff. DS0000062504.V263382.R01.S.doc Version 5.0 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 x x x x Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 2 x 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x 2 x DS0000062504.V263382.R01.S.doc Version 5.0 Page 21 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 YA35YA42 Regulation 18(1(a (c)(i)(ii Requirement All staff must attend mandatory training and any other essential training identified by the home to ensure safe working practices and ensure the health and welfare of service users. (A training plan providing sufficient courses for all staff to be up to date this year to be provided by timescale) 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. (previous timescale March 2006) Timescale for action 30/05/06 2. YA39 24(1) (a,b(2(3 31/05/06 DS0000062504.V263382.R01.S.doc Version 5.0 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 YA22 Good Practice Recommendations To continue developing the complaints procedure so that it can be accessible to service users. DS0000062504.V263382.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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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