Inspection on 27/11/07 for The Hadlows

This inspection was carried out on 27th November 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Hadlows 27/02/07

The Hadlows 18/05/06

The Hadlows 22/02/06

The Hadlows 21/09/05

The Hadlows 01/11/04

The Hadlows 16/06/04

The Hadlows 22/11/03

The Hadlows 03/06/03

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

CARE HOME ADULTS 18-65 The Hadlows 128 - 130 Hadlow Road Tonbridge Kent TN9 1PA Lead Inspector Anne Butts Key Unannounced Inspection 27th November 2007 10.00a The Hadlows DS0000023879.V345827.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 Hadlows DS0000023879.V345827.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 Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Hadlows Address 128 - 130 Hadlow Road Tonbridge Kent TN9 1PA 01732 355646 01732 359527 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) Evesleigh (Kent) Limited Post Vacant Care Home 10 Category(ies) of Physical disability (10) registration, with number of places The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users accommodated will have been assessed as having an acquired brain injury. To accommodate one service user whose date of birth is 19 July 1939. Date of last inspection 27th February 2007 Brief Description of the Service: 128 and 130 Hadlow Road comprises of two houses one of which is an end terrace property the second adjoining. It is registered for ten people who have a diagnosis of acquired brain injury and offers all single rooms; five rooms in each house. Facilities are in both houses and accommodation is spread over three floors. The homes are not suitable for people with significant mobility difficulties as there is no lift between floors. The two communal lounges are located on the first floor along with two bedrooms and bathroom/WC. The second floor has the staff office/ sleep in room and one further bedroom and bathroom facility. There are two bedrooms and a walk-in shower facility/WC on the ground floor with access to a linked walk through dining room. Small kitchen and laundry area. There is no separate visitors room or communal space located on the ground floor. The home is located approximately 1½ miles from the centre of Tonbridge where there are all the facilities of a town including shops, eating places, pubs, churches, a Post Office and banks. The nearest main line station is approximately 2 miles away and the nearest bus stop 50 yards away. The home has limited car-parking facilities to the front of the building and on street parking to the side of the property. There is a garden to the rear of each house, which service users are able to use. The fees are £1100 - £1200 per week as listed in the Statement of Purpose. A copy of the last inspection report is available at the home. The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection that took place over the course of one day and was carried out by one inspector. The focus of the inspection was to review key standards and follow up on improvements made since the last inspection. Time was spent touring the building, talking to staff and reviewing assessments, care plans and other relevant documents. Time was also spent observing as to how service users are assisted in their day-to-day living and talking to people who live in the home. There has not been any new service users move into the home since our last visit. What the service does well: What has improved since the last inspection? There are risk management strategies and guidelines in place and evidence was seen of multi-disciplinary meetings with service users. The home is continually aware of making sure that any new people moving into the home are properly assessed prior to admission. The manager stated that they would not accept emergency referrals without due processes being adhered to. Training opportunities have improved with staff benefiting from training in areas such as acquired brain injury and non-physical intervention methods. Supervision is now taking place on a regular basis. The Hadlows DS0000023879.V345827.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 Hadlows DS0000023879.V345827.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 Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with adequate information, but further safeguards within individual contracts would protect the people using the service. EVIDENCE: The Statement of Purpose has been updated and is made available to all service users. Information is now contained within referring to the fee structure. The Statement of Purpose still names the responsible individual as someone who is no longer working for the organisation. Information is incorporated into the document about the services that are provided and there is a copy of the complaints procedure. People are given individual contracts, but one file showed that this had not been updated or signed – in order to fully protect the people living in the home contracts must be signed by the service user or their representative and the manager. There has been no new service users move into the home since our last inspection. There are procedures in place and the Manager was able to The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 9 describe the process. This included making sure that prospective service users have a full assessment of need undertaken prior to moving into the home The returned Annual Quality Assurance Assessment also stated that people are given the opportunity to visit the home and meet with current service users prior to moving in. The home does not accept emergency referrals due to the support needs of the people living in the home and the manager stated that they will only accept people whose needs they can meet. The Hadlows DS0000023879.V345827.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 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are supported to make their own daily living choices and decisions. However individual changing and ongoing needs could be better reflected in care plans and risk assessments that would enable people to meet individual goals. EVIDENCE: All service users have an individual file that contains details of their care plans, known as an essential living plan, assessments, health care needs, reviews and guidelines. Three files were viewed and these showed that that they are written in a style that evidences individual people have a say in their care planning process. People’s life history is discussed and this forms the basis of the care plans. The information in the care plans includes individual preferences, people and things that are important to them, areas a person feels that they need support in and guidelines on helping people manage behaviours. Members of staff spoken with on the day of the visit confirmed The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 11 that there is a key worker system in place and that they work closely with each person in maintaining and supporting their daily living needs. People are supported with maintaining a structured routine and they are supported in managing any restrictions on freedom of choice if a risk has been identified. There is, however, a great deal of information within the care plans and this can make is difficult for staff to be fully aware of any identified changing needs. This was particularly noticeable with regards to key worker reviews. For example where a change in goal or ambition was identified at a review or a changing support need then this had not been reflected into updated guidance. In February a service user had identified that they would not be returning to college, but there was no support system implemented. Another review stated that a person wanted to access additional counselling, but again there was no evidence to show how they were being supported with this. Monthly reviews have not recently been taking place on a regular basis and staff stated that this was due a shortage of time. Although the home recognises that people need support with making decisions the system in place does not always allow for this to be carried through. The home must make sure that care plans are working documents that reflect changing and individual needs. This is particularly important as due to different levels of physical and psychological disability following brain-acquired injury each service user requires different levels of support, motivation and prompting with everyday living and leisure skills. Memory retention can fluctuate and requires special support and skills from staff in maintaining personal dignity and respect of individuals and managing behaviours. There are substantial risk assessments in place and these are supported by guidelines on the agreed support outcome. These assessments identify the risks and any positive or negative outcomes for people. Again, though, some of the information within these was not easy to access and the flow of information into the care plans was not easy to navigate. Evidence from reviews had not been updated into relevant guidelines. Staff spoken with on the day of the inspection did, however, demonstrate a good working knowledge of the individual needs of the service users living in the home and were able to describe outcomes. The Hadlows DS0000023879.V345827.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 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People benefit from daily support, but individual ongoing needs and goals are not always promoted and sustained. EVIDENCE: Service users benefit from the home recognising their individual needs and people are supported with accessing community resources. Where people have been assessed as being able to manage independently in the community they travel to and from work or college without support. Other service users are escorted out as needed. Two service users attend the local Headway centre, two attend college and one service user has employment in the local Sainsbury’s. One service user, who is older, prefers to stay at home rather than attend college courses. The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 13 Care plans indicated people’s choices about their lifestyles and their preferred hobbies. Each service user has a reasonably structured routine, although members of staff and a service user confirmed that this is flexible and dependant upon their needs at the time. The home has explored individual people’s aspirations for the future and has identified goals to help achieve this, however these goals are not regularly updated in order to help people achieve their ultimate aspiration. For example one service user has stated that he would like to live independently in the community and part of the goals to help to achieve this were about supporting him with household chores and managing alcohol. Reviews showed that there had either been no progress made and in one instance there had been a set back. These goals had not been revisited and reviewed on a regular basis. Family support, where appropriate, is promoted and encouraged and there was evidence seen in files of involvement from families. Individual service users are also encouraged to identify who is important to them. The Annual Quality Assurance Assessment (AQAA) stated that ‘activities could be more varied, accessing more social settings to enable service users to form meaningful relationships’, and it acknowledged that the home has recognised this and a recommendation is being that they continue to source this in order to improve opportunities for people living in the home. It is acknowledged that staff (spoken with on the day of our visit) recognise people’s needs and are responsive to them. There was evidence in the care plans that people are supported with making decisions about their menus and mealtimes, and how they should be supported. Staff stated that people are supported with arranging their preferred menu choice and can choose what they would like to plan ahead. Meal preparation is part of building upon daily living skills and they are supported in taking turns in preparing meals. This is more pro-active in number 130, where people are more dependent. Staff confirmed that there are no set menus and is dependent upon peoples preferences. It is also acknowledged that where any service user has a particular preference of food or prefers not be involved in a more communal mealtime activity – then their preference is acknowledged and supported and people are able to get their own shopping and prepare their own meals. The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are supported with their individual healthcare needs appropriately, however referrals for psychological help are not always followed up. The systems for medication do not serve to fully protect the service users living in the home. EVIDENCE: Evidence, through talking to people, staff and records showed that people are only supported in their personal care needs through a prompting and supervisory role. There are robust records supporting people’s physical health care needs, and these evidenced that individual health care needs are promoted. People are supported in accessing the GP and other healthcare professionals as needed. Again, though, any changes in needs are not always reflected through the care planning process and a review in July showed that a letter had been sent for a psychiatric assessment, there was however no evidence of any follow up to The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 15 this. Staff did confirm that they were still waiting for the outcome of this and that they had followed this up with phone calls, records do need, however, to evidence any action taken. Overall people’s medical and health needs are recognised and the home is pro active in seeking specialist referrals and support. People are supported with their medication and where possible they will self medicate. Records showed, however, that the systems within the home need reviewing. There are no systems in place for checking medication in and out of the home and the information on medication administration records (MAR) did not correlate with that on individual bottles or boxes. There had been handwritten changes made on a MAR sheet, but the information on the bottle had not been changed in accordance with this. When asked why the change a been made a member of staff stated that the MAR sheet had been inaccurate for some time and that all staff were aware of what the service user needed, but there were no records to support this. There were gaps in the MAR sheets and no explanation as to why this had occurred and the amount of medication provided did not always correspond with those being administered. The records within the home are not robust so leading to the opportunity for mistakes to be made. Requirements are being made with regards to medication. The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home have confidence in raising any concerns and know these will be listened to and acted upon. Staff are fully aware of the importance of safeguarding the people living in the home. EVIDENCE: There is a complaints procedure in place and two service users spoken with during our visit stated that they had confidence about speaking to staff if they had any concerns. Staff confirmed that they supported service users with any complaints and demonstrated an awareness of individual needs. There have been no complaints made to us since the last visit. Restrictions on freedom of movement are in place for service users due to individual behaviour management, cognitive ability and brain-acquired injury. This does affect personal choices and human rights but there are risk assessments and strategies in place to support this – these have been agreed with the individual. Service users are promoted in safeguarding their safety and welfare, with staff demonstrating full awareness of issues surrounding abuse. Staff are trained in this area and each individual service user has been risk assessed as to their vulnerability in the community and guidelines are in place for supporting The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 17 people with this. Conversations with staff also evidenced that they were very aware of the need to protect vulnerable adults and were able to describe in detail what action they would take if they had any concerns. Members of staff confirmed that they had been trained in behaviour management so that they are able to support service users appropriately. The Hadlows DS0000023879.V345827.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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, homely and clean environment, although there is limited communal space. EVIDENCE: The two homes are situated next door to each other and symmetrical in design and layout. There is a ground floor comprising of two bedrooms, corridor leading to a small dining room, which you have to walk through to get to the very small kitchen, leading to the WC, shower room and laundry. Overall both properties were clean and well maintained, the manager did state that there were plans to join the two homes together by making an access door on one of the floors, this was currently being reviewed by the larger organisation. The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 19 Due to layout of the properties communal space is limited, service users did not voice any particular concerns with regard to this and all staff were aware of the limited space. People are free to choose where they prefer to be. There is an ongoing refurbishment programme in place and some redecoration has been carried out since out last visit. People living in the home who were spoken to as part of this visit stated that they were happy. The requirements made with regards to the environment made at the last visit had mainly been met with toughened glass being installed, window restrictors in place and radiator covers provided. There are still no appropriate facilities for staff to sleep in with both houses having a sofa bed placed in the individual offices. Members of staff stated that these were uncomfortable and not suitable for their needs. The larger organisation needs to review the sleeping arrangements for staff and this requirement remains outstanding. The Hadlows DS0000023879.V345827.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 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that they are supported by caring staff that respect their choices and preferences, and have benefited from appropriate training and supervision. The recruitment procedures are not robust and therefore do not fully protect people living in the home. EVIDENCE: The Hadlows is set out in two different buildings, with a staff team based in both. Each house has two members of staff on duty at any one time and a member of staff who sleeps in at night. Three members of staff and the manager were available during out visit. Although staff are mainly based in house or the other in order to maintain continuity, there is some cross over of staff. Staff confirmed that there is a key worker system in place and that their main role was to prompt and support people rather than assist with personal care. The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 21 Staff spoken to confirmed that when activities were organised or people needed support in accessing the community then additional staff were allocated to help out. The manager confirmed that the use of agency or bank staff had now decreased. Three staff files were viewed, these all showed that application forms had been completed, proof of ID obtained and a Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) check obtained. Two of the three files showed only one reference on each file and the home must make sure that two written references are obtained prior to confirmation of employment – a requirement is being made with regards to this. Induction training has improved since out last visit, with evidence on files of staff completing a structured induction programme. This is carried out over a six week period with staff being supported in administrative and safety procedures and the needs of the people living in the home. There were records of training on individual staff files including movement and handling, health and safety, fire safety, basic food hygiene and adult protection. Staff have also undertaken service user specific training for people with acquired brain injury. Staff spoken to on the day confirmed that they had received training including managing challenging behaviour and awareness in drug and alcohol abuse. Two members of staff did state that they would like some more service user specific training for people who needed other support in areas such as diabetes. There is still a limited amount of staff who have obtained an NVQ, and the home needs to continue to support staff in accessing and obtaining this qualification. Supervision has improved since our last visit with records of supervision on file and confirmation from staff that this occurred. The Hadlows DS0000023879.V345827.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 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are benefiting from a stable management team that is engaged on developing in the service in order to meet service users best interests. EVIDENCE: The manager has now been in position for just over a year and this has led to stability of management within the home. The manager confirmed that he was continuing to develop the staff team and address the environmental improvements; although there were times when he felt the administrative procedures within the larger organisation for agreement of work could slow things down. The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 23 Staff confirmed that they felt well supported and things had improved with regards to the management of the service. The home is very open and transparent where staff are confident in speaking openly to the inspector and other staff members. Staff are encouraged to express their views and opinions in staff meetings and through the Regulation 26 visits. The home has access to an estates manager who makes sure that issues around the maintenance of the building and health and safety checks are carried out. Service users are supported in actively having their say and making decisions about the day-to-day running of the home. People stated that they felt well supported by staff. The larger organisation has systems in place for quality assurance management and this is supported through the Regulation 26 visits for quality monitoring. Service users have daily one – to – ones with staff who confirmed that any concerns or issues are dealt. There was no evidence of any formalised feedback from service users and their families although it is acknowledged that individual views are actively sought. The Hadlows DS0000023879.V345827.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 2 3 X 4 X 5 2 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 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 2 12 2 13 2 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 2 X X 2 X The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 YA5 Regulation 5 Requirement Timescale for action 29/02/08 2. YA6 14 (2) 3 YA20 13 (2) The registered provider must make sure that all service users have an individual signed contract. Where changes in needs, 31/01/08 goals or aspirations are identified the care planning process must reflect how people will be supported with this. The registered person must 31/01/08 make sure that there are safe arrangement for the administration and record keeping for medication in that: There must be a clear audit trail of medication received into and leaving the home. There is clear guidance on individual service users medication. There are regular reviews. Medication supplied by the pharmacist must be at the correct dosage. The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 26 MAR sheets must correspond with the information on any boxes or bottles. Boxes and bottles should be dated as when they were opened in order to monitor any expiry dates. 4. YA34 19 The registered person must make sure that two written references are obtained prior to confirmation of employment. The registered person shall having regard to the size of the care home, the statement of purpose and the needs of the service users, ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they perform including making sure that 50 of staff hold the NVQ level 2 or above. A plan must be put in place to address this. The registered person shall provide for staff suitable facilities and accommodation including storage facilities that is lockable for personal belongings and medication. This requirement had not been fully met with an original timescale date of 06/04/07. 30/01/08 5. YA32 18(1)(c)(i) 30/04/08 6. YA24 23(3) (a)(ii) 29/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 27 No. 1. 2. Refer to Standard YA13 YA24 Good Practice Recommendations It is recommended that opportunities for people to access more varied activities and social settings be actively promoted. It is strongly recommended that a review of the premises is undertaken so that the areas and equipment in need of replacing or redecorating are identified and that a time scale with planned refurbishments is made. This has been partially addressed from the last inspection and the home should continue with any refurbishment programme. It is strongly recommended that a review be made of the premises and equipment by a suitably qualified person to ensure that service users who have mobility or other physical needs are catered for. This remains outstanding from the last inspection. Service users whose bedrooms are facing the main road would benefit from their windows being double glazed/ replaced to offer better soundproofing and noise reduction. It is strongly recommend a formal quality audit be undertaken by the company to ascertain service users, relatives and visiting professional’s views about the home and current service provided. 3. YA29 4. 5. YA26 YA39 The Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 28 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 Hadlows DS0000023879.V345827.R01.S.doc Version 5.2 Page 29 - 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!