Inspection on 22/06/07 for The Goodwins

This inspection was carried out on 22nd June 2007.

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

Other inspections for this house

The Goodwins 22/08/06

The Goodwins 04/01/06

The Goodwins 20/09/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Goodwins 3 St Richards Road Deal Kent CT14 9JR Lead Inspector Tina Thomas Key Unannounced Inspection 22nd June 2007 10:00 The Goodwins DS0000065342.V340266.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 Goodwins DS0000065342.V340266.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 Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Goodwins Address 3 St Richards Road Deal Kent CT14 9JR 01304 389149 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) CareTech Community Services (No.2) Ltd Post Vacant Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd August 2006 Brief Description of the Service: The home is a two-storey, detached property. It is currently owned and operated by Care Tech Community Services. The home is registered to provide residential care for up to eight persons at a time, aged from 18 years to 64 years, who have a learning disability. In terms of access and scope for community access, the home is located on the outskirts of the coastal town of Deal, with all the community and transport links that implies, and it is within five minutes walk of the nearest bus stop and railways station. The home has on site parking for four vehicles, including its own adapted minibus and there is unrestricted kerbside parking off site. There is a small back garden and patio area for the service users’ use. The current fees for the service at the time of the visit range from £1,249.42 £2,398.82 per week. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. It was conducted over a one day period. The manager was not present for the site visit. The inspector was assisted by another manager within the Caretech Group who had covered the management of the home during the interim period between the registered manager leaving and the new managers commencement of employment. The inspection process consisted of information collected before and during the visit to the home. Other information seen included assessment and care plans, medication records, duty rota and employment paperwork. What the service does well: What has improved since the last inspection? The home is cleaner. Some bedrooms have been refurbished so that people living at the home can enjoy their private space. Some work has commenced on improving care plans so that they are in a format that is assessable to the people they are for. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 6 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 Goodwins DS0000065342.V340266.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 Goodwins DS0000065342.V340266.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 adequate. This judgement has been made using available evidence including a visit to this service. The home does not have sufficient current information for prospective service users, their relatives or Commissioners of services to make an informed decision regarding what the home has to offer on a day to day basis. The home has implemented a new admission process to ensure that they can meet the needs of people who may wish to live at the home. EVIDENCE: It was recommended at the last inspection of 28/08/06 that the home update its Statement of Purpose and Service User Guide this has not been undertaken. It was last reviewed in 2005. The home has a service user guide which is in pictorial form to aid people living at the home or prospective service users, who prefer this method of communication to understand what can be expected in day to day life at the home. Caretech have implemented a thorough and holistic admission process for any new admissions to the home. The home has had no recent admissions so it was not possible to assess how staff would implement the new process. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 9 The Goodwins DS0000065342.V340266.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): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care planning needs to evolve further and become more person centred. Communication methods used for non-verbal communicators have not improved sufficiently, or in a timely manner. Decision-making processes are not well documented. Risk assessments maximise the capacity of people at the home to be independent. EVIDENCE: Each person living at the home has a plan of care. The staff have made an effort to improve care plans and are aware that they need to be developed further. Some key workers have progressed further than others with the development of plans. This means that they are not all of consistent quality. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 11 Some key workers have worked with people living at the home and have developed some good quality pictorial aids, which has enabled them to be inclusive documents. There were shortfalls identified in the care plans regarding reference to people’s hopes, dreams and aspirations. There were also no communication logs in care plans of people who did not communicate verbally. Whilst permanent staff may understand how people living at the home, agency staff would not have the benefit of understanding that when someone does this, it means this. The plans established individualised procedures for people likely to be aggressive. Staff were seen to handle several situations in line with the information and risk assessments in care plans. They quickly de-escalated situations leaving people living at the home happy. Decisions made on behalf of the people living in the home are not always well documented. This was recognised particularly in regards to one person’s religious views. There had also been no plans put in place regarding one person’s religious needs at point of death. Care plans held suitable risk assessments, which enabled people living at the home to undertake activities with minimal risk. Limitations were only made in the person’s best interest. The Goodwins DS0000065342.V340266.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, 13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are available and the programme of activity is actively evolving to increase opportunities and include people living in the home in decisionmaking. Some service users have regular contact with family and friends. Service users are offered a healthy diet. EVIDENCE: People at the home are generally assisted by the staff to find suitable activities. The home also buys in a specialist agency, which works with people at the home in meaningful activities. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 13 People at the home enjoy using the conservatory and the garden. The garden needed mowing and there was a lack of activities in the garden to meet the needs of all the people in the home, for example one person may benefit from inflatable equipment. In its absence the person had to improvise inappropriately to provide their own entertainment. The manager has described in the annual quality assurance assessment his plans to improve further the scope of activities and involvement of people living in the home in decision-making. Where possible people at the home are assisted to attend courses at the local college and one is currently undertaking a cooking course. People at the home are supported to maintain contact with relatives and this is described in their care plans. The home has a mini bus and staff assist people at the home to maintain links with the local community. People living in the home can generally choose when to get up and go to bed, whether to go out or stay in – the home’s daily routines are organised around this, accepting some would have day centre or other commitments. Staff are respectful at all times to the people living in the home. The staff conduct well-documented nutritional assessments for each person living in the home. Records regarding food intake and enjoyment are of good quality. A range of snacks and drinks are also available at all times. The Goodwins DS0000065342.V340266.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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support needs clearly documenting and staff are consistent in their approach. Physical health needs are generally well met and medication management is sound. EVIDENCE: Staff were seen to support people living at the home with dignity and inline with their care plans. The home has a key worker system and the induction of new staff includes personal care issues. People’s health care needs are addressed in their care plans. Caretech have produced a health action plan, for the recording of health care issues but as yet it has not been included in the care plans at this home. Care plans showed that people had access to health care specialists as required. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 15 The home has suitable policies and procedures regarding the ordering, storage, administration, and disposal of medication. Staff administering medication are suitable trained. The Goodwins DS0000065342.V340266.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): 22,23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The company has a complaints procedure, but it was not available in accessible formats to meet the special requirements of the people living in the home. Staff are aware of adult protection issues. Staff endeavour to protect the dignity of the people living at the home. EVIDENCE: The home has an updated complaints policy and procedure. It is not in a format that is assessable to the people that live at the home. A previous requirement regarding this matter with a timescale of 31/12/06 has not been met. People that live at the home have an opportunity to raise complaints in their weekly talk times with their key workers. However, without pictorial aids or without any communication log directions, concerns may prove difficult to detect. The staff tend to rely on peoples behaviours as prompts. The new manager has planned that in the next year methods should be explored which more fully enable people at the home to express their concerns. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 17 Staff spoken with showed a good understanding of adult protection issues. They also expressed that they would not tolerate any abuse of the people that live in the home and would readily report it should it ever occur. Staff all undertake adult protection training. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 18 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): 24,25,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally clean, free from odours and fit for purpose. Though currently, the standard of decor throughout the house is not consistent. Peoples own bedrooms are generally comfortable and well decorated and furnished. EVIDENCE: The standard of the property is adequate. The furniture is domestic in style, and comfortable. Residents have a choice of communal areas, including a sensory area. There are homely touches throughout. There has been an ongoing programme of redecoration in the home. Some areas have been redecorated whilst other areas are still in need of redecoration. The manager has produced a maintenance audit to identify areas The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 19 in need of attention. The maintenance department has been restructured so that it is now given timescales for work to carry out. The manager plans that in the next 12 months to seek the support of Caretechs recently introduced quality assurance department. Sometimes within the home there are breaches of health and safety for example fire doors on bedrooms were pinned back, one bedroom door did not close properly and a broken radiator cover had not been replaced. All people living at the home have their own bedrooms. Bedrooms are clean and most are newly decorated. They reflect the personalities of the people they belong to. The home is generally clean and free from offensive odours. A regular cleaning rota has been introduced. Staff spoken with all expressed how much cleaner they thought that the house was recently. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 20 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): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at the home are supported by staff that understand and react appropriately to their needs. Recruitment practices at the home ensure the safety of the people that live there. Staff are generally well trained, although numbers of staff trained in NVQ Level 2 in Care, fall short. EVIDENCE: Staff were observed to have a good knowledge of the needs of the people they were supporting. They were respectful and consistent in their approach. All staff undertake a six-month Learning Disability Awards Framework (LDAF) induction and foundation training at commencement of employment. The number of staff qualified to NVQ Level 2 in care falls short of what is required by the national minimum standards. The new manager recognises this and plans to ensure that these numbers are increased within the next twelve months. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 21 Staff files were not available for viewing on the day of inspection. They had recently been audited and revised by a group manager. An assurance was given that they met the requirements of Schedule 2 of the Care Home Regulations. The home conducts staff selection in accordance with the companies clearly defined recruitment policy. All staff have CRB checks prior to the commencement of employment. Conversation with staff and the staff training matrix evidenced that staff undertake a good level of training, which includes mandatory, and service specific training. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 22 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): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s quality assurance processes and internal auditing identify the home’s strengths and weaknesses. Further attention needs to be paid to health and safety provision. EVIDENCE: Since the last inspection the registered manager has left his post. His absence was covered by another of CareTech’s managers. In May the new manager Martin Field was appointed. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 23 Martin has the qualifications and experience to manage the home, but has not yet undergone the registration process or ‘fit person’ interview in order to become the registered manager. Martin has completed an annual quality assurance assessment, which has demonstrated that he has already recognised many of the strengths and weaknesses of the home. The home uses a number of quality assurance tools and internal audits. As previously mentioned Caretech has also recently introduced a quality assurance department. As previously mentioned in the report there are some health and safety concerns in the home. Fire doors were found to be pinned back. One person’s door did not close properly. A broken radiator cover had not been repaired. These things all put the people that live in the home at risk of harm. Some of the home’s policies have not been reviewed for over a year. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 24 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 2 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 2 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 2 x The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 25 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 YA22 Regulation 22 Requirement There needs to be an accessible format for the company’s complaints procedure, to meet the needs of the residents Previous timescale 31/12/06 NOT MET 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. 1 Refer to Standard YA22 Good Practice Recommendations The home needs to look for opportunities to translate expressions of dissatisfaction into recordable events, so as to demonstrate the effectiveness of its complaints procedures. The Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 26 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 Goodwins DS0000065342.V340266.R01.S.doc Version 5.2 Page 27 - 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!