Inspection on 07/12/05 for The Cherries

This inspection was carried out on 7th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Cherries 30/01/09

The Cherries 10/10/07

The Cherries 26/06/06

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

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 Cherries 30 Julian Road Folkestone Kent CT19 HW Lead Inspector Julie Sumner Unannounced Inspection 7th December 2005 10:00 DS0000050913.V258562.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 DS0000050913.V258562.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. DS0000050913.V258562.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Cherries Address 30 Julian Road Folkestone Kent CT19 HW 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) Parkcare Homes (No2) Ltd Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places DS0000050913.V258562.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th July 2005 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. It is a large detached home with a spacious driveway in front and garden with patio at the back. All rooms are spacious and airy and all bedrooms are single. 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 6 current service users have a contract for one-to-one support. The home is situated close to Radnor Park, the town centre and Folkestone leisure centre. DS0000050913.V258562.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 starting 10:45 and finishing at 4:30 pm. All service users were in the home at different times during the day and participated as much as they were able to with the inspection. A manager is in post but there has been some delay with the application for registration being received by CSCI. This needs to be addressed as soon as possible. Two service users have moved into the home since the last inspection, so that the home is now fully occupied. The group of people now living at the Cherries are compatible so far and service users and staff are getting to know each other. There have been some recent staff shortages due to a combination of staff leaving and the need for a higher staff level as the home is fully occupied. Recruitment is in progress. Service users are young and have moved on from home, schools and children’s placements. Staff are supporting current interests and also giving new and different opportunities for them to experience and discover what other activities they like. Service users need a lot of support to keep well and healthy and to be able to go out so have a high level of staff. During the inspection a range of methods were used to gather information including: being in the communal areas of the home and spending some time with staff and service users including eating lunch with them, discussion with acting manager and reading and discussing individual support plans, risk assessments, selected policies, completed staff training records and certificates. What the service does well: Service user plans are well written and have utilised relevant information from their families. Families are involved with care and support as much as they wish to be. Staff spend time with service users giving them lots of positive attention and supporting them with different activities in the home. DS0000050913.V258562.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. DS0000050913.V258562.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 DS0000050913.V258562.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): There are clear and informative assessments completed for new service users. EVIDENCE: A sample of service user plans were viewed containing assessments using the company’s assessment tool. DS0000050913.V258562.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, 7, 9 There are good service user plans and risk assessments that are designed to meet individual needs and develop independence. Service users communication skills are being effectively supported to develop. EVIDENCE: A sample of service user plans were viewed and discussed. There were examples where service users have developed their social skills and there was some discussion about including this in more detail to illustrate this development and the changes in support to continue the development. A recommendation has been made to make sure the written plans are in sufficient detail to demonstrate developing skills or changing needs. Risk assessments were also viewed and were varied to promote independence and provide a safe framework. Staff had observed changes in need with regard to health risks to individuals and had varied their approach to support. Good interaction was observed between service users and staff. One service users was observed to demonstrate more confident behaviour and communication since the last inspection. DS0000050913.V258562.R01.S.doc Version 5.0 Page 10 DS0000050913.V258562.R01.S.doc Version 5.0 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): 14, 17 Service users are offered new opportunities to develop their experience and life skills within a risk assessed framework. There needs to be further development of day-to-day activities and sufficient staff to make sure these can be carried out at the planned frequency. A good variety of healthy meals are offered with regard to preventing allergic reactions. EVIDENCE: Three service users were taken on holiday during the summer for the first time and this was a success. Service users have previously had difficulties in unfamiliar places but they behaved in a relaxed way and there were no significant incidents of challenging behaviour. A variety of in-house and community activities are offered by the home staff. Some service users attended activities provided by the company’s occupational activities unit but this has now closed. Outreach staff support to assist with activities has been considered but has not been successfully implemented yet. Service users were supported by allocated staff during the shifts. One service DS0000050913.V258562.R01.S.doc Version 5.0 Page 12 user went out swimming, others went out walking and into town. There have been variations in the level of support needed to assist in going out and risk assessments have been reviewed to reflect this but the need for higher levels of staff has limited some of the opportunities. The manager was changing the activity programmes to reflect changes in need, changes in provision and what is available locally. It would be beneficial to have some support with activities externally to give service users a wider variety of people to interact with and further experiences. A recommendation has been made in respect of this. The home has changed its philosophy with regard to the meals provided. Meals are prepared using fresh meat and vegetables which are bought locally. Staff commented on the improvement of behaviour since providing less processed foods in the menus. Staff have always been conscious of the ingredients in foods purchased because of the need to check for allergy advice but have been able to provide more variety in the menu by having more home cooking and the ranges have increased in the supermarkets. It is also possible to enable service users to participate in the local shops because they are less crowded, there are less distractions and shopkeepers and service users get to know each other. DS0000050913.V258562.R01.S.doc Version 5.0 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 Behaviour that needs to be supported in order to be socially acceptable is managed and supported in a way that maintains individual dignity. Medication storage and administration is conducted safely. Individual risk assessments for administration of medication need to be up to dated to be fully effective. EVIDENCE: Staff were observed interacting with service users in a polite and positive way. The staff team have found a creative way to resolve a difficulty one service user has with controlling excess salivation which is discrete and effective. Behaviour that challenges is managed calmly. Staff were observed diverting service users from less sociable behaviour. There is a mixture of planned activities and service user lead activity. Staff have allocated amounts of time with service users one-to-one during each shift. It had not been possible to organise staff training in the use of the epipen but the manager said that this would still be pursued. There were guidelines in the service user’s care plan for staff in the event of severe allergic reaction. Medication storage and MAR sheets were viewed. There are detailed PRN protocols and procedures for those with medical conditions requiring DS0000050913.V258562.R01.S.doc Version 5.0 Page 14 recognition of symptoms and intervention when necessary. Some of the procedures need to be reviewed. A recommendation has been made for this. DS0000050913.V258562.R01.S.doc Version 5.0 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 The company has an effective complaints procedure. There are effective procedures in place to protect service users from risk of abuse. EVIDENCE: There is a complaints procedure and one is on display on the information notice board in the entrance hall. There are various versions to assist people with disabilities and/or sensory difficulties. There is a tracking book and complaints forms are available to be completed individually (including anonymously) and maintaining confidentiality. The home has had one complaint this year about noise which is being addressed by the company. The manager and staff team have attended adult protection training. The company has a procedure in place. The manager has reported incidents appropriately and has contacted the adult protection coordinator and followed advice and protocols. Two incidents have been reported to both CSCI and the social services adult protection coordinator. One resulted in an investigation and one resulted in an increase in staff support for the individual concerned and both are now closed. DS0000050913.V258562.R01.S.doc Version 5.0 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 The home is warm and homely providing a spacious and comfortable environment for service users. There is insufficient ventilation in the laundry room causing damage. EVIDENCE: A tour of the home was undertaken. Sensory equipment had been purchased for the sensory room. There was some additional furniture providing further comfort. Bedrooms are spacious and furniture has been purchased based on individual need and preference. The laundry room was not in a good state of repair. There was considerable visible damage due to excessive damp and poor ventilation in the room. A faulty window was due to be replaced but there were no evident plans to address the lack of adequate ventilation and the subsequent mould/mildew and water damage to the room. A requirement has been made to address this and make the room fit for its purpose. DS0000050913.V258562.R01.S.doc Version 5.0 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, 33 NVQ training is progressing. There is a good core staff team but there needs to be more staff in the team to support all service users one-to-one at all times. EVIDENCE: Four staff have completed NVQ 2, one team leader has just commenced NVQ 3 and one staff has commenced NVQ 2. Staff demonstrated positive, motivated attitudes to their role when spoken to. They enthusiastically spoke about how the service users’ life skills are developing. The staff duty rota was viewed and discussed. There have been some difficulties in making sure there are sufficient staff on duty to fulfil the one-toone contracts agreed at all times. This is partly because the home has not been fully occupied and running on a smaller staff team, 2 staff leaving and recruitment not being quick enough. There has been the need to have the support of other staff from other homes within the company to boost the staffing level since the home has been fully occupied. The manager has also worked additional hours to fill some of these gaps. The manager is recruiting and there has been some interest. There were sufficient staff on duty at the time of the inspection. A requirement has been made to ensure that there are sufficient staff in the team to meet individual needs at all times. DS0000050913.V258562.R01.S.doc Version 5.0 Page 18 DS0000050913.V258562.R01.S.doc Version 5.0 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, 38, 39, 42 The manager needs to be registered. The manager has a clear vision and direction for the home to continue to improve and develop the service. The quality assurance process needs to be strengthened to include views of service users and other significant people involved in their care. Overall the home is well maintained and environmental risk assessments have been carried out appropriately. Further risk assessment and safety measures need to be in place around the additional heaters. EVIDENCE: The manager is not registered. A requirement has been made to make an application for this. The manager has identified priorities in the home and has been addressing these. They focus on developing the independence, social and communication skills of service uses and making sure that staff are clear DS0000050913.V258562.R01.S.doc Version 5.0 Page 20 in their roles and have the skills to fulfil them. It was evident from observation that progress has been made regarding individual development. The company uses a home audit questionnaire that is completed annually by the manager to measure the quality of the service. This covers the care, support, staff training and skills, range of activities, the standard of décor and building maintenance and facilities etc. Some areas were identified for improvement this included the range of activities. Service user views have not incorporated. Service users should be given the opportunity to give their views. It is acknowledged that some individuals have significant difficulties with understanding and communication but this should not prevent them participating in some way with the audit. Other people that are important to service users and have some involvement in their care could also participate and give their views. A requirement has been made to strengthen the quality assurance process. All staff have attended statutory training and other relevant training is ongoing. There are some problems with the home’s heating system. The company’s maintenance department have arranged to have an alternative heating system installed in the spring. To provide additional heating some free standing heaters have been purchased and the home felt warm and comfortable. Risk assessments need to be carried out and appropriate action taken to make sure they are safe. DS0000050913.V258562.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score 3 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 3 x x x x x 1 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 2 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 1 x x x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 1 3 1 x x 2 x DS0000050913.V258562.R01.S.doc Version 5.0 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. 2. Standard YA24 YA30 YA33 Regulation 23 (2)(b) 18 (1) (a) Requirement Timescale for action 10/02/06 3. 4. YA37 YA39 9 (1) 24 (1)(a b) (3) Address the cause of excessive damp and repair damage in the laundry room. Make sure that there are 10/02/06 sufficient staff recruited in the team to carry out planned activities fully and fulfil one-toone contracts and meet assessed needs at all times. An application to be registered 27/01/06 manager needs to be submitted to CSCI. Develop the quality assurance 17/03/06 system in the home to include views from service users and significant others involved in their care and form the basis of the home’s business/service development plan. 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 DS0000050913.V258562.R01.S.doc Version 5.0 Page 23 1. 2. 3. 4. YA6 YA19 YA20 YA33 To make sure the individual service user plans are in sufficient detail to demonstrate developing skills or changing needs. To continue to pursue training for staff in the administration of adrenalin and use of the Epipen. Individual PRN procedures/guidelines for staff need to be reviewed. The length of shift time needs to be reconsidered to shorter amounts of time with breaks to enable staff to be able to support individuals most effectively. DS0000050913.V258562.R01.S.doc Version 5.0 Page 24 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000050913.V258562.R01.S.doc Version 5.0 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. 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