Inspection on 13/07/07 for The Bungalow

This inspection was carried out on 13th July 2007.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Bungalow 22/11/06

The Bungalow 02/02/06

The Bungalow 30/06/05

The Bungalow 19/01/05

The Bungalow 15/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

33 St John`s Church Road

Dovedale Court

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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 The Bungalow 150a Crabble Hill Dover Kent CT17 0SE Lead Inspector Joseph Harris Key Unannounced Inspection 13th July 2007 10:00 The Bungalow DS0000023248.V343141.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 The Bungalow DS0000023248.V343141.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. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Address 150a Crabble Hill Dover Kent CT17 0SE 01304 825739 01304 827411 hillbrow@robinia.co.uk 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) The Robinia Care Group Ltd Mrs Julie Ann Staveley Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users are restricted to three (3) service users with learning disabilities between 18 and 65 years of age. Service users are restricted to One (1) service user LD/OP whose DOB is 13/04/1940. 22nd November 2006 Date of last inspection Brief Description of the Service: The Bungalow is run by Robinia Care and supports people with a learning disability. The Bungalow is registered to provide personal care and support to up to 3 adults between 18 and 65 who have a learning disability. The Bungalow is situated in the grounds of a larger Robinia home. Both homes are managed by the same registered manager but are inspected separately. The Bungalow is intended to provide support for more independently skilled service users and also for service users who benefit from living in a smaller home. It is also suitable for service users with some mobility difficulties but is not currently adapted for wheelchair use. The home is situated on the outskirts of Dover in a residential area near to amenities with easy access to the main bus route/train station to the town. The home also has the use of a car for shopping, outings or visits to the service users’ families. The fee for this home is approximately £92,000 per year. For more information about the fee please contact the Provider. Previous inspection reports are available from the Provider. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection process culminated in an unannounced site visit to the service on 13th July 2007. The inspection commenced at 10am and finished at approximately 3.30pm. During the course of the visit discussions were held with the deputy manager and 1 resident. A tour of the home was undertaken and a range of documents were examined including those relating to service users, staff, health and safety, medication and the running of the home. The Annual Quality Assurance Assessment had not been returned prior to the start of the inspection and, therefore could not be taken into consideration. What the service does well: What has improved since the last inspection? The home has addressed all of the requirements and recommendations raised at the previous inspection. Service user plans have been improved and updated providing a personcentred approach to the care and support needs of the residents. The statement of purpose and service user’s guide have been updated and are now more accessible to those with communication difficulties. New monitoring systems have been introduced for the recording and reporting of incidents. Risk assessments have been reviewed and updated reflecting perceived risks and promoting responsible risk taking. Quality assurance systems have been further developed providing a measurable and action focused approach to service development. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 6 The organisation now provides a greater range of training topics with more emphasis on person-centred issues. 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. The Bungalow DS0000023248.V343141.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 The Bungalow DS0000023248.V343141.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, 4 and 5. Quality in this outcome area is good. Service users are able to make a positive choice about moving into the home and are provided with good levels of information about the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no new residents at the Bungalow for a number of years, but good systems are in place to ensure that prospective service users are provided with clear and accessible information through the statement of purpose and service user’s guide. It was reported that in the event of any service users moving into the home in the future, as in the past, that they will be residents already residing in Robinia care homes who are aiming to move towards a more independent lifestyle. Therefore the assessment of needs will be clearly targeted towards independent living skills and lower levels of support. The transfer of information would be consistent and prospective residents would have flexibly arranged time to spend in the home and work through the transition process. The home has an assessment pro-forma and liaises closely with care managers to ensure all relevant information is received. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 9 Each service user file had a contract in place, which is easy to read and accessible to people with communication and reading difficulties. It was reported that staff would work through the contract with any prospective service users to aid understanding if necessary. All relevant information is contained within the contract. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10. Quality in this outcome area is good. Service users’ individual needs and choices are assessed and supported. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has completed a significant amount of work to update care plans developing a more person-centred approach. The service user plans are detailed, covering health, support and care needs as well as aspirations and goals. Support plans are in place, which are written in the first person providing a narrative explanation and bullet points summarising key aspects of support. In addition care plans are in place covering healthcare needs in similar detail. Plans are reviewed and there is clear evidence of service user’s involvement in the development of these plans. Residents are supported to make decisions regarding their day-to-day lives. Two of the residents are responsible for their own food shopping and cooking The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 11 and handle their own finances. One resident required a greater level of support in all of these areas, which is managed appropriately. Two of the residents in the home actively participate in the running of the home from involvement in household chores, cooking and daily living tasks to involvement in the selection of new staff. Another resident participates to an appropriate level and this level of involvement is supported and promoted by staff. The home has developed a range of comprehensive risk assessments relating to each of the service users specific needs and perceived risks. The risks are managed in a positive manner promoting responsible risk taking where possible. The risk assessments are reviewed and updated regularly. All information in the home was seen to be maintained in a private and confidential manner. Staff address issues of confidentiality through the induction process. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. Service users can expect a lifestyle appropriate to their needs and expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents in the home are able to choose the activities that they engage in on a recreational and occupational level depending on interests and abilities. Some residents have secured jobs and attend college courses. One resident spends her time involved in a range of recreational activities. The home has developed weekly planners for all service users taking into account personal needs and interests. The majority of activities are accessed outside the home, although some are brought into the home. Staff have flexibility to be able to support service users in the community if they wish and to spend 1:1 time in the home. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 13 Visitors are welcomed into the home with the agreement of service users including family and friends. The staff support service users to maintain friendships and more intimate relationships appropriately. Residents are able to determine how they live their lives and their routines on a daily basis. Residents have keys to their rooms and the house and staff respect individual’s privacy. “The staff help me when I need it, we all get on well.” Two residents now budget, plan and prepare their own meals with staff supporting them in this, as a planned step towards independence. Staff prepare meals for one service user who has special dietary requirements and menu records demonstrate that a healthy and balanced diet is provided. The input of a dietician has been sort with regard to menu planning in this regard. One resident said, “I get £20 a week to buy my shopping. I enjoy cooking and like being independent”. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. Service users’ personal and healthcare needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One service user requires some support with personal care needs, which are clearly and thoroughly addressed through the care and support planning process. The organisation has also made necessary adaptations to the home following an occupational therapy assessment to ensure that this individual’s needs can continue to be met by the service. There are flexible routines in place to ensure that residents can choose when they get up and go to bed and with regard to all other aspects of personal care. The home maintains clear and accurate records relating to healthcare needs and input. One resident has experienced a number of healthcare issues and there are clear records relating to all of the input and consultation received recording reasons for healthcare input and the relevant outcomes of any consultations. Other service users are supported to maintain responsibility for The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 15 their own healthcare needs appropriately. All service users have a care manager and receive regular support in this respect. Medication issues are appropriately managed in the home with suitable storage facilities and clear and up to date medication administration records. Policies and procedures are in place and staff receive adequate training and undergo an in-house competency assessment prior to administering medication in the home. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Service users are protected from abuse and their views are listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a clear and accessible complaints process in place. One service user stated that she would feel comfortable raising any concerns or complaints if she had any and felt confident that they would be acted upon. There have been no recorded complaints since the last inspection. Policies and procedures are in place regarding abuse awareness and adult protection protocols. All staff address these issues through the induction process and have additional adult protection training. Staff working in the home are trained in physical restraint techniques and de-escalation methods. The incidence of use has been significantly reduced and all incidents are clearly recorded and monitored following the introduction of new systems. It was reported that there are no adult protection issues on-going or raised regarding the service. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29 and 30. Quality in this outcome area is good. The premises are well-maintained and suitable for the individual needs of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises demonstrated that the home is suitable for purpose. The environment is well furnished and decorated in a warm and homely manner. The deputy manager reported that works are carried out promptly and maintenance issues addressed. There is a domestic style kitchen and laundry facilities suitable for the needs of the home. The home benefits from a large lounge/dining room and there is an additional quiet room available. There is a small office/sleep-in room, which is unobtrusive and does not detract from the homeliness of the environment. All of the bedrooms are single occupancy and service users are free to personalise them to their tastes. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 18 An occupational therapy assessment has been carried out and adaptations made to the environment in line with the recommendations made to ensure that the needs of one service user can continue to be met including the provision of a sit-in shower cubicle and grab rails. The home, on inspection, was very clean, hygienic and well maintained. Hazardous substances are appropriately stored and staff are given instruction in infection control and universal precautions. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is adequate. Service users are supported by a competent and well-trained staff team. Recruitment practices should be reviewed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two of the staff working in the home have achieved an NVQ level 2 or above and one other member of the team is currently working towards this award. Two team members have recently joined the service and are working through CWLPD training, which is an NVQ based induction programme specifically for working with people with learning difficulties. Two of the staff are under 21 years of age, but the registered manager has put a risk assessment and oncall systems in place using the attached home, Hillbrow, for back-up systems in the case of emergency. Staff work through a detailed induction programme covering organisational and service specific issues as well as the CWLPD training. Mandatory training is kept up to date and the organisation has a training manager who ensures that staff are updated and refreshed in these topics as required. In addition to this The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 20 there are a number of other courses available through the organisation such as Equality and Diversity, mental health capacity, autism, diabetes, valuing people and intensive interaction. The home is allocated 1 place per course and staff attend these as their training needs require. 2 staff files were examined and all required information including two written references, proof of identity and evidence of CRB and POVA checks were in place. However, the organisation should review the information on the application form with regard to employment history. Currently the last 5 years of employment are requested. It is advised that a seamless working history should be requested covering all previous employment and unemployment. The two staff files demonstrated a number of gaps in employment history and no evidence that these gaps had been explored. Refer to requirement 1. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 21 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 and 42. Quality in this outcome area is good. The home is well run and quality is monitored. Health and safety practices promote the welfare of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has been in post for approximately 3 years and has many years of experience in the field of care work. She has achieved her NVQ level 4/RMA and is currently studying for a degree in person-centred planning. She is registered manager for the Bungalow and Hillbrow, which are adjacent to each other and manages her time effectively between the two services. The organisation has introduced a good quality assurance and monitoring system including a range of service audits, monthly monitoring visits, The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 22 satisfaction surveys and annual reports for both the service and the organisation as a whole. Outcome and issues raised from these processes are put within an action plan and measured. Evidence was available to demonstrate that issues raised through these processes and through inspection by regulatory bodies are taken on board and addressed. All health and safety documentation including fire safety logs, accident records and service maintenance checks were in place and up to date. Policies and procedures are in place to underpin safe working systems and environmental risk assessments are completed and updates as required. The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 23 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 3 5 3 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 3 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 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 The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 24 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. Standard YA34 Regulation 19 Requirement To ensure all employment history for staff is requested and any gaps in this information explored and documented satisfactorily. Timescale for action 01/09/07 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 The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 25 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 The Bungalow DS0000023248.V343141.R01.S.doc Version 5.2 Page 26 - 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. 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