Inspection on 10/10/07 for The Cherries

This inspection was carried out on 10th October 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 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

The Cherries 30/01/09

The Cherries 26/06/06

The Cherries 07/12/05

The Cherries 07/07/05

The Cherries 23/11/04

The Cherries 05/05/04

The Cherries 03/02/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

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Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Cherries 30 Julian Road Folkestone Kent CT19 5HW Lead Inspector Wendy Gabriel Key Unannounced Inspection 10th October 2007 10:00 The Cherries DS0000050913.V352146.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 Cherries DS0000050913.V352146.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 Cherries DS0000050913.V352146.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Cherries Address 30 Julian Road Folkestone Kent CT19 5HW 01303 259561 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) Craegmoor Homes Ltd Ms Hannah Wilkinson Care Home 6 Category(ies) of Learning disability (0) registration, with number of places The Cherries DS0000050913.V352146.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. 3. Learning Disabilities (LD). The maximum number of service users to be accommodated is 6. The home may only accommodate service users between the ages of sixteen to twenty five years of age. 26th June 2006 Date of last inspection Brief Description of the Service: The Cherries is registered to provide care and support for 6 young people with profound learning disabilities and complex needs. Residents must be within the age range of 16 – 25 years. The home is a large detached building with adequate communal space and single bedrooms. There is limited parking to the front drive but parking in the road outside. A large, well maintained garden to the rear is accessible to the residents. There is no lift or access for a person with physical disabilities. There is a high level of staff support to service users living in the Cherries; all of the six current service users have a contract for one-to-one support. The home is situated close to the centre of the seaside town of Folkestone with its varied amenities and public transport. The current fee range for this service is £1478 to £2015 per week. For further information please contact the provider. The Cherries DS0000050913.V352146.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was fully staffed during the unannounced inspection. Residents were engaged in various activities. Staff discussed planned outings to suit the choices of individual residents. Training took place during the inspection as part of several days of varied training in the home that week. Three requirements made at the previous inspection have been met. The change of registration to younger adults between the ages of 16 and 25 has been undertaken with consideration to staff training in child protection and PoCA checks for staff. There was written evidence of refurbishment and redecoration being undertaken and planned for, including a new kitchen in February 2008. During the inspection, an accompanied tour of the premises was undertaken, some records and policies and procedures seen and a discussion took place with the Registered Manager. The Registered Manager introduced the Inspector to residents. Although communication was limited, there was evidence of warmth and empathy between staff and residents. What the service does well: Staff training is enthusiastically promoted by the Registered Manager and supported by the company. There was evidence of mandatory training being given to staff as well as more specialist courses for the needs of the residents within the homes registration category. The home maintains an action plan for their quality improvement plan. Activities are varied and include visiting facilities away from Folkestone to allow residents to experience public transport. Regular health checks at well man clinics, GP reviews and medication reviews are undertaken. This is good practice. The Cherries DS0000050913.V352146.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Cherries DS0000050913.V352146.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 Cherries DS0000050913.V352146.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available for an informed choice of placement to be made. Residents know their needs will be assessed, that they may visit the home and that the home will meet their aspirations. EVIDENCE: The statement of purpose has been amended to account for the change of registration to age group 16years –25years. There was pre admission assessment information from the home, the care manager, school, speech and language therapy reports and a health assessment for the most recent resident. Staff have undertaken child protection training and PoCA checks have been undertaken to meet the requirements of the age range. There is opportunity for visits to the home before a decision is made for a permanent placement. A contract was seen for one resident and the Registered Manager said that they are usually held at the company head office. The Cherries DS0000050913.V352146.R01.S.doc Version 5.2 Page 9 The Cherries DS0000050913.V352146.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to take risks, to make choices and participate in different aspects of life in the home. Confidential information is secure. EVIDENCE: Person centred plans have been recently reformatted by the company and included a wide range of information detailing personal care, psychological needs and risk assessments. The Registered Manager said that some parents had been able to input information including background and likes and dislikes. A simple and clear process for evaluating risks and updating where necessary is included in daily recording. The Cherries DS0000050913.V352146.R01.S.doc Version 5.2 Page 11 The Registered Manager discussed means of obtaining views and opinions from residents. Communication can be limited and staff learn to recognise body language. Choices can be encouraged for example by putting a variety of food choices on view at breakfast time. Picture cards are also used and these can be adjusted to ensure residents recognise each picture. One resident has been supported to attended the company area conference that is a forum for residents to discuss issues around their life styles. Staff sign a document regarding maintaining confidences. The Cherries DS0000050913.V352146.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have opportunities for varied activities as part of the community. Appropriate relationships with family and friends are enabled. Menus reflect specialist diets and choices EVIDENCE: There was ample written evidence of activity plans, including pictorial format for individuals. Activities include swimming, martello ball games, badminton, a walking group, social club, gardening, trips to Lydd airport, pub, Gateway club, disco, relaxation where ‘chill out’ music is played, train trips to Ashford and Deal for bowling, photography sessions, woodwork, computer, local park ball games, cinema, foot massage, roller skating and using a trampoline. Trips using public transport are encouraged to encourage community contact for residents The Cherries DS0000050913.V352146.R01.S.doc Version 5.2 Page 13 as well as experience train and bus rides. Another co-owned home has a farm and residents access the area for vegetable growing. The home is looking at local colleges for suitable courses. Since the last inspection the registered manager has tried to improve residents input into menu choices. The registered manager said that she and the staff are still working on this. Pictures are used but mainly she stated that staff would put, for example, a selection of cereals and other foodstuffs in front of residents at breakfast for them to choose. The Registered Manager stated that staff are aware of the body language of individuals to know if the choice is the actual preferred choice. Once a week residents are given money to go to the supermarket and choose food they like and bring it home to cook for their meal, with staff support. Menus are varied and include fresh vegetables and fruit. Specialist diets are catered for. The registered manager said that for most of the residents there is good family support, for example a planned trip to Euro Disney will include some parents. The registered manager confirmed that entertainments are age appropriate for the younger age group. Some residents have been to Blackpool for the week this year and others with different preferences will go out daily but be based at home. The home attends the ‘area conference’ that is organised by the local coowned homes and that enables representatives of residents in the homes to meet and be supported to discuss their feelings about life in the homes. One resident from The Cherries is supported to attend. The registered manager discussed sexuality and confirmed that staff have received suitable training. An educational psychologist has supported the home with one resident. The Cherries DS0000050913.V352146.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive physical and emotional support to meets their needs. Medication policies protect residents. Residents know that if they become ill or die that this will be handled with respect. EVIDENCE: Since the previous inspection the home has improved the recording of health appointments. Medication is kept in a secure environment and medication administration sheets were recorded correctly. Policies are in place and a regular audit from the company’s clinical governance team is undertaken. A member of staff was observed giving medication to one person and this was done in a calm and suitable manner for the resident. Staff used appropriate methods for diverting behaviours and the person centred plans identify personal needs and how staff should support residents. The Cherries DS0000050913.V352146.R01.S.doc Version 5.2 Page 15 The Registered Manager has recently looked at suitable ways of staff dealing with illness and death of residents. Although this is a subject not easy to discuss with relatives, the Registered Manager has recorded where possible; relatives and residents wishes. This is good practice. The Cherries DS0000050913.V352146.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know that they are protected from abuse by staff training and the homes complaint policies. EVIDENCE: The home has a concern and complaint book for any person to record in on display in the entrance of the home. A complaint policy is on display and is also in a picture format. A recording format is maintained to log and record the process of any concern or complaint raised. The home has given training to staff on child protection to meet their current registration for residents between 16 and 25 years. All staff had PoCA checks in line with the registration. CRB checks are undertaken. Although some communication limitations may prevent residents’ from fully voicing their concerns, the Registered Manager said that families are generally very involved in the welfare of their relatives living in the home. The Cherries DS0000050913.V352146.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is safe comfortable and hygienic. The residents benefit from homely and spacious bedrooms and communal areas. EVIDENCE: The home undertakes a regular health and safety audit via the company and regular maintenance of the premises is undertaken. The garden was tidy and paving slabs on a patio area had been cleaned since the previous inspection. Some furniture in the home had just been replaced and the old furniture was outside awaiting removal. Bedrooms are individual and one bed had been modified to meet that needs of the occupier. Approval had been obtained from the relatives of the occupier. The stair carpet is due for updating the Registered Manager said. The home was clean and tidy and hygienic. The laundry is kept locked and a previous The Cherries DS0000050913.V352146.R01.S.doc Version 5.2 Page 18 condensation problem has been resolved. The kitchen is tidy and well organised. The Registered Manager said that the kitchen is due to be replaced in February next year. Staff has infection control training and basic food hygiene training. The company health and safety committee has approved work around the home including earthquake damage, flooring and carpeting in various areas and some redecoration to lounges and bedrooms. The Registered Manager said that some locks were being altered to meet the abilities of the residents. Communal areas are sufficient for the numbers of residents and include two lounges and a dining area. The Cherries DS0000050913.V352146.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported and protected by recruitment procedures and by staff training. EVIDENCE: The Registered Manager confirmed that the home is currently fully staffed and that the one to one requirements for individual residents can be met. The Registered Manager spoke with great enthusiasm about training for staff. The company has facilities for arranging training and just has to be accessed by the Registered Manager. A trainer was in the home that afternoon and again that week for health and safety training. The trainer confirmed that his company was employed to undertake a wide variety of training in the home. Core training is undertaken and specialist training is also given including awareness of different needs of the client group in the home. A four day course has been undertaken by all staff on Prevention and therapeutic management of violence and aggression. The Cherries DS0000050913.V352146.R01.S.doc Version 5.2 Page 20 Training certificates were held in the two staff files viewed. The files also contained appropriate employment records including references and CRB and POVA checks. CRB checks are authorised by the homes divisional manager. Applications are sent to the company head office who then hires depending on POVA outcomes. New staff undertake induction and will shadow an established member of staff for some time before being allowed to undertake personal tasks. A member of staff spent some time arranging a morning outing for one resident and explained why he enjoyed that particular activity. Staff and resident communication was observed to be appropriate and friendly. Residents are assigned key workers. Staff receive supervision and this has improved since the previous inspection. The Registered Manager said that timing had been better organised now to ensure supervision targets are met. The Cherries DS0000050913.V352146.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home and are protected by health and safety procedures and policies. Residents are encouraged to express their views. EVIDENCE: The manager has met a previous requirement to become registered. The Registered Manager is enthusiastic about training and stated that she will seriously consider any training opportunity for herself and staff. Residents’ communication varies and staff employs mainly body language to aid residents choices and preferences. Families have annual questionnaires. Residents from The Cherries and other local company owned homes may attend Area Conference Forums where willing residents are supported to discuss their home and what they would like to do or to change. The The Cherries DS0000050913.V352146.R01.S.doc Version 5.2 Page 22 Registered Manager said that residents are encouraged before the forum to plan questions they would like to ask. A recent question was “how does it make you feel when staff come in happy or unhappy”. This is good practice and being involved in such forums can enhance residents self esteem. Quality assurance data includes healthcare information. The home has a quality improvement plan and includes an action plan. Medication is reviewed annually, the clinical governance team audits medication and healthcare, audits also are undertaken for health and safety and finance. Maintenance checks were in place for electric, gas, fire safety, water safety and food hygiene. Generic health and safety checks are regularly reviewed. The Cherries DS0000050913.V352146.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 4 3 3 4 3 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 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 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 3 3 X 3 X X 3 X The Cherries DS0000050913.V352146.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Person centred plans are to be completed. 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