Inspection on 26/09/06 for The Bungalow

This inspection was carried out on 26th September 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 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Bungalow 14/11/08

The Bungalow 08/09/08

The Bungalow 07/03/06

The Bungalow 22/08/05

The Bungalow 12/11/04

The Bungalow 24/05/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

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 The Bungalow Dennes Lane Lydd Kent TN29 9PU Lead Inspector Mrs Sally Gill Unannounced Inspection 26 September 2006 09:15 th The Bungalow DS0000023184.V300731.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 DS0000023184.V300731.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 DS0000023184.V300731.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Address Dennes Lane Lydd Kent TN29 9PU 01797 321612 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) Parkcare Homes (No2) Ltd Ms Janet Clayton Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th March 2006 Brief Description of the Service: The Bungalow is registered to provide accommodation for up to 4 adults with a learning disability and admits service users with low dependencies. The home is owned by Parkcare Homes (No 2) Ltd. The registered manager Mrs Janet Clayton is in day-to-day control of the home. The premise is a detached colt bungalow. All service users have their own bedroom. One of which has an ensuite shower and two others have a wash hand basin. The accommodation includes a large lounge/diner, kitchen, utility room, shower room, bathroom, and conservatory/smoking room which is accessed from outside. The home is surrounded by gardens, which are well maintained with patio, lawn with fishpond and mature borders/shrubs. There is also an additional fenced area with chickens, geese and ducks. The Bungalow is situated in a quiet lane on the outskirts of Lydd. Within walking distance in Lydd there is a library, pubs, and café’s and selection of shops. Lydd also has a golf club and airport. There is a regular bus service from within Lydd to Folkestone. The current fees range from £1572.89 to £1905.31 per week. The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced site visit took place on Tuesday, 26th September 2006 between 9.15am and 5.45pm. The registered manager assisted throughout the visit. Four people were living at the home. The inspector spoke to all service users and staff on duty. Observations included interactions between service users and staff. The inspector accessed the lounge/diner, a toilet, the office, the garden and two service users bedrooms. The inspection process consisted of information collected before and during the visit to the home. Surveys were sent to service users, families, and the community leaning health team and care managers. Surveys were received from all service users (completed with staff support) and three relatives. Feedback was on the whole very positive. Various records were viewed during the inspection. What the service does well: What has improved since the last inspection? Further improvements have been made to the medication system although there is still work to complete. The commission now receives copies of accidents/incidents affecting service users but when the registered manager is away this process falls down. The statement of purpose and service users guide has been reviewed to reflect changes in the home. A weekly programme of available activities has been agreed with each service user, which is written down, and they have a copy. The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 6 Names and address of where to report abuse outside of the home has been recorded on the whistle blowing policy within the office. 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 Bungalow DS0000023184.V300731.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 DS0000023184.V300731.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Prospective service users have the information they need to make an informed decision about the home. Prospective service users individual aspirations and needs are assessed. EVIDENCE: The registered manager said that the statement of purpose and service user guide have both been updated to reflect the changes within the home. There has been one new admission since the last inspection. The company has introduced a new assessment format for assessing prospective admissions, which is used to feed the care plan. Completed assessments were seen on service users files. The home had also obtained a copy of the care manager’s assessment and other professional information prior to admission. Service user files contain contracts of terms and conditions. The Bungalow DS0000023184.V300731.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users assessed needs are reflected in their care plans although for one a review is overdue. Service users are supported to take risks and make decisions regarding their day-to-day lives. However a lack of staff skills could be isolating one service user and not allowing full participation within the home. EVIDENCE: Each service user has a care plan in place, which is developed from the assessment of needs. Care plans evidenced service users involvement/agreement. A previous recommendation that service users would sign the reviews of their care plan had not been actioned. It was agreed with the registered manager that service users would only sign when any changes were made to their care plans rather than every monthly review. A review must be held for one service user as recommended by the adult protection strategy meeting. The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 10 The registered manager stated that regular house meetings are held although minutes are not always taken. Minutes evidenced meetings held in August and March only. Service users said that they are usually able to make decisions in their day-to-day lives. One service user has communication needs and uses Makaton but only one staff member has been trained to use this form of communication, which is not acceptable. The inspector acknowledges the achievement by the home already to improve communication but all staff must have the skills to fully communicate with all service users to ensure they are not isolated and can participate fully within the home. Service users are supported to take appropriate risk and risk assessments are documented on individual files. The Bungalow DS0000023184.V300731.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. Service users enjoy a variety of appropriate activities both in-house and in the community. Staff support contact with families and friends. Service users daily responsibilities are not fully recognised and daily routines do not encourage a healthy lifestyle. Service users enjoy a varied diet however this is not a healthy diet. EVIDENCE: A structured weekly programme of varied activities has now been developed and recorded for each service user. The inspector was advised that unfortunately the local colleges have reduced their pathway courses considerably, which has now left gaps in the weekly programmes. Only one service user is attending a course. The company as a result are putting The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 12 together some activity workshops within the area. Records should show where service users are offered opportunities for activities but they are refused. Service users have opportunities for access to the local community. There are regular visits to the library for Internet access, boot fairs, markets, pubs and shops. In-house activities include looking after the chickens and ducks, maintaining the gardens, jigsaws, television including sky and art and craft. Service users talked about their annual holiday, which this year was to Chichester and obviously enjoyed by all. Service users confirmed that they maintain links with their families and friends via telephone calls and visits. Service users are involved in the day-to-day running of the home participating in tasks such as some cooking, room clean and laundry. However given the service users abilities the inspector feels this could be greatly increased and developed. On the day of the inspection only one service user got their own lunch, which was rolls, crisps and coke. The inspector questioned why the other service users had theirs prepared for them and was advised that this was not normal practice. The inspector has raised this at previous inspections and has been given the same answer. Service users should be getting their own lunch or at least always involved in these sorts of tasks. One service user told the inspector they had “cooked the Sunday lunch a roast” which is commendable but they had not prepared their lunch on the day of the inspection. Service users are able to smoke either in the garden or the conservatory. It was apparent on the day of the inspection that service users and staff spend a considerable time either smoking or rolling batches of cigarettes and there appears to be an ethos of promoting smoking rather than encouragement towards reducing smoking. Staff should be more proactive in promoting the benefits of good health and this is in relation to diet and smoking. The inspector viewed the record of food, which although evidences a varied diet does not evidence a particularly healthy diet. This was further confirmed by the lunch on the day of the inspection and also the records of weight, which evidence that service users are gaining weight, and in some cases quite considerable weight. One service user is on a special diet and although there is a list of yes/no foods there has been no planning of their menus with them to give a healthy diet. In fact comments from other service users stated that the yes/no list ‘are not taken any notice of by X’ or ‘only when it suits does X they take any notice’. Staff have a responsibility and duty of care to promote a healthy diet. Mealtimes were relaxed with plenty of interaction. The inspector was advised that service users no longer go to the supermarket for shopping, as it was their choice to complete this on the Internet. However this does not mean staff should undertake this task. The Bungalow DS0000023184.V300731.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 &20 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users are supported in the way they prefer. Healthcare needs are met mainly in the community but a lack of encouragement for a healthy lifestyle could put service users at risk in future. Minor improvements to the medication system will fully protect service users. EVIDENCE: Staff provide personal support to service users as required. Input from professionals is accessed and advice taken on board. An agreed strategy for continence promotion was discussed, as it is evidently not working. It is recommended that the strategy be discussed with the service user and a more realistic strategy agreed. Each service users has a key worker. Service users have access to healthcare professionals mainly within the community including annual checks. The medication is supplied using a monitored dosage system and improvements have been made. The MAR charts reflected medicines were The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 14 administered as prescribed. Clear PRN instructions are in place for staff. Medication must be logged into the home. Internal and external medication should be stored separately. Seven staff are trained in administration of medicines. The Bungalow DS0000023184.V300731.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users feel their views are listened to and acted upon. Service users are protected from abuse. EVIDENCE: No formal complaints have been received since the last inspection. Service users are able to record any grumbles in a book and one had been recorded since the last inspection. Appropriate action had been taken to resolve the issue. All service users felt that their views and any concerns would be listened to and acted upon. A complaints procedure is displayed. The whistle blowing policy has been reviewed and the external route identified. However the inspector noticed that an old policy was still displayed within the home. Staff confirmed that they are aware of where to report abuse outside of the home. Appropriate checks are carried out before staff are employed within the home. Ten staff are trained in adult protection and eight in CPI although all staff are given an overview during their induction. Since the last inspection two adult protection alerts have been raised. Both are now closed. However not all the recommendations made have been implemented (hold a review for service user) and the home must ensure this is achieved. The balances and records of service users personal allowances were checked and appeared in order. The Bungalow DS0000023184.V300731.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users live in a clean, homely, comfortable and safe environment. EVIDENCE: On the day of the inspection the home was clean and well maintained. One bedroom cupboard door needed repair but the service user advised the inspector this had just broken. Service users all stated that they were happy with their rooms. An area of the grounds in the front is still not in use after work undertaken last summer. However the registered manager advised this is now in hand. Relevant procedures are in place to ensure infection control. The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 17 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): 32, 34, 35 & 36 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Robust recruitment procedures protect service users. A qualified staff team supports service users but the team lack the right skills/training to communicate fully with all service users. Staff feel well supported although there are still staff who do not receive regular formal supervision. EVIDENCE: Five staff have achieve an NVQ level 2 or above and one is currently undertaking which will give 50 . Staff are currently undertaking LDAF induction if they have not already obtained NVQ. The changes in standards and timescales for Skills for Care were discussed. Robust recruitment procedures are in place and followed. One staff member has attended Makaton training but it is a requirement that all staff attend given the communication needs of one service user. Some staff has undertaken training in understanding difficult behaviour. The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 18 Staff said they felt well supported by the manager and the deputy manager and there was a good team spirit. Previously it was recommended that staff receive regular formal supervision. The inspector was advised there is still slippage on formal supervision timescales. The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 19 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 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The manager does not have the relevant qualification to manage the home. A variety of quality monitoring is in place to ensure the home is run in the best interests of service users. The health and safety of service users is promoted although some reporting still requires improvement. EVIDENCE: The registered manager has still not obtained her RMA because there is problem with the companies training provider. The registered manager must have the relevant qualifications. Staff felt the manager was very open and approachable to service users and staff. The ethos in the home is relaxed and laidback with an open door policy. The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 20 The company and home have a variety of quality assurance systems in place. Seven staff are trained in manual handling, ten in fire, six in first aid and food hygiene, eight in infection control. Core training is updated annually. Further courses are booked for first aid and food hygiene. Accidents were recorded appropriately. There has been some improvement in reporting of accidents/incidents to the commission. However there must be systems in place that are followed by staff when the registered manager is not in the home. Records were checked in relation to fire and other health and safety checks and all were in order. The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 21 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 2 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x 2 X 3 X X 2 X The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 22 No 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 YA6 Regulation 14(2) 15(2) 12 18(1) 19(5) 16(2)i Requirement Hold a review for the service user as recommended by the adult protection strategy meeting. All staff to be trained/skilled to communicate fully with all service users The home must involve and encourage service users in achieving a healthier lifestyle (smoking and diet) All medication received by the home must be recorded with quantities clearly (Previous timescale of 30/08/05 and 31/03/06 not met) Internal/external medication must be stored separately In the absence of the registered manager any event affecting the well being of service users or the running of the home should be reported to CSCI within 24 hours Timescale for action 26/11/06 2 3 YA8 YA7 YA32 YA35 YA16 YA17 YA19 YA20 26/12/06 26/10/06 4 13(2) 26/10/06 5 YA42 37 26/10/06 The Bungalow DS0000023184.V300731.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard YA6 YA12 YA16 YA19 YA36 Good Practice Recommendations Changes of care plans should be signed by the service users to indicate their agreement (brought forward from previous inspection) Where opportunities for activities are offered to a service user and refused this should be recorded Service users must have further opportunities to maintain and developed independent living skills Review with service user programme for continence management Regular staff supervision should be implemented (brought forward from previous inspection) The Bungalow DS0000023184.V300731.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: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Bungalow DS0000023184.V300731.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!