Inspection on 20/02/06 for The Hailey

This inspection was carried out on 20th February 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Hailey 30/08/07

The Hailey 06/07/06

The Hailey 08/08/05

The Hailey 25/08/04

The Hailey 14/04/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 The Hailey 7/8 The Downs Herne Bay Kent CT6 6AU Lead Inspector Mark Hemmings Unannounced Inspection 20th February 2006 10:00 The Hailey DS0000058573.V272795.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 The Hailey DS0000058573.V272795.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 Older People and 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 Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Hailey Address 7/8 The Downs Herne Bay Kent CT6 6AU 01227 742969 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) All About Care Ltd Care Home 33 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (26), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (7) The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The condition ,that continued registration is conditional upon the application process being Satisfactorily completed by 31st December 2003 8th August 2005 Date of last inspection Brief Description of the Service: The main part of the premises are two older two-storey properties which have been joined together and adapted for their present use. The accommodation for service users is arranged on each of the floors. On the ground floor there are various lounges and other communal areas. The first and second floors are used for service users bedrooms and there are also toilets and bathrooms on these levels. To the rear of the main buildings, there is a suite of purpose built bedrooms. When the Home is full, there is provision for two of the bedrooms to be shared. The remaining bedrooms all offer single occupancy. All of the bedrooms have a wash hand basin, with those in the new build section having a full en-suite service. The newly built bedrooms form a quadrangle with the main building. This is a popular area with the service users because it is out of doors while at the same time being private. To one side of the site, there is also a more conventional garden area. The Hailey looks out over The Downs and out to sea. It is only a short distance from Herne Bay’s town centre and so offers ready access to a range of community based facilities. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was announced and it took about two hours to complete. During this time, the Inspector spoke with or spent time with six service users. Also, he spoke with the Registered Manager and with the Deputy Manager. The Inspector examined various records and he spoke with two of the support workers. The Inspector looked at various parts of the accommodation. This included (by invitation) two of the service users’ bedrooms. The Home continues to provide the service users in residence with the support and assistance they need. Service users say that they remain satisfied with the provision made for them in The Hailey. The Inspector did not examine all of the Standards on this occasion. Consequently, the reader is asked to read this Inspection Report in conjunction with previous Inspection Reports. This should assist the reader to obtain a more detailed account of the Inspector’s current evaluation of the adequacy of the facilities and services available in the Home. There are no Required Developments at the end of this Report What the service does well: The assistance each service user receives is provided in consultation with them and takes place within a prudent assessment of potential risks to health and safety. A suitable balance has been achieved between engaging service users in everyday activities and respecting their need for private space and for quietness. There is a stable staff team and the Registered Provider is understood to have validated the adequacy of the competencies possessed by each support worker, so as to enable them to safely and reliably respond to service users’ changing needs for assistance. The Home’s catering service is well organised and service users consider the food served to be enjoyable and sufficient. Generally, suitable arrangements are operated in the Home to help safeguard the health and safety of the service users. The Hailey DS0000058573.V272795.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. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Prospective service users are given the information they need to make an informed decision about living in the Home. Service users’ needs and aspirations are assessed before they move into the Home. Service users are confident that the Home will enable their needs for assistance and support to be met. Prospective service users have the opportunity to visit then Home before deciding about moving in. Each service user receives a written statement of the terms and conditions of their residency. EVIDENCE: There is a Service Users’ Guide. This is a brochure which prospective service users are given and which outlines the facilities and services provided in The The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 9 Hailey. In addition to this, the Registered Manager speaks with prospective service users to answer any remaining questions they may have. The Registered Manager meets with each prospective service user to assess their needs for assistance. This is done to ensure that these needs can be met reliably in the Home, should the admission proceed. Previously, service users have observed to the Inspector that they were confident at the point of admission to the Home, that they knew what was on offer and that this would meet their needs. Also, they have observed that their expectations of the services they hoped to receive, had been met. Previously, service users have said that they were encouraged to visit the Home at least once before they made a decision to move in. They consider this to have been useful because it gave them a first hand impression of what daily life is like in The Hailey. Previously, the Inspector has established that all of the service users have a copy of the contract of residence. This document gives a suitably detailed account of the terms and conditions in accordance with which the Registered Providers deliver accommodation and care services in the Home. The Inspector understands that the Registered Manager continues to take the time to speak with them about the document in order to answer any questions they may have had about its contents. This is an important part of the admission process. This is because it helps to clarify further the rights and the responsibilities which attach to a service user’s decision to move into the Home. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9. Service users are confident that their present and future needs for personal care will be met in a reliable and consistent manner. They are suitably consulted about both the assistance they receive and the day to day running of the Home. Service users are supported in taking prudent risks. EVIDENCE: There is a service user plan for each service user. These documents describe the assistance the service user in question has agreed to receive. The Inspector sample checked several of these plans and he found them to be suitably detailed. Service users say that they are consulted about the contents of the plans and that they are fully involved in periodic reviews of their The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 11 contents. Service users consider that they receive all the assistance they need. Support workers assist service users in a manner consistent with that described in the individual service user plans. Service users are assisted to take those reasonable risks which are part of everyday living. The Registered Manager is aware of the need to keep this matter under careful review. This is so that service users are assisted to avoid situations in which their own welfare or those of others may become jeopardised. A number of the service users continue to smoke cigarettes in their bedroom. The Registered Manager said that this practice has been reviewed carefully and that in each case the arrangement has been assessed as not compromising the Home’s fire safety regime. The Registered Manager is aware of the need to keep this subject under particular scrutiny, given the significance of the potential consequences. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Service users have access to a suitably varied range of social and vocational activities, some of which involve engagement with the local community. Service users are assisted to maintain contacts with family and friends. Service The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 13 users are enabled to exercise their citizenship rights and to respect those of other people. Service users are offered a suitably healthy diet. EVIDENCE: Service users undertake a range of social and vocational activities. Service users say that they are consulted about what they want to do and that staff assist them to access the necessary resources. The Inspector witnessed a several of these events taking place during the course of the inspection visit. Most of these involved service users leaving the Home in order to go the shops to purchase everyday items such as newspapers and cigarettes. Service users consider their time to be occupied appropriately. The Registered Manager and the support workers are aware of the need to strike an appropriate balance between engaging with service users and recognising their needs for quiet time. This is an essential element of good practice within the Home, because it assists the service users to maintain and to promote aspects of their mental health. The Inspector understands that the service users continue to be assisted to maintain helpful contacts with members of their families and with friends who do not live in the Home. Service users say that they continue to be provided with good quality meals and that they always have enough to eat. On this occasion, the Inspector did not join service users for a meal. However when he last did so, he noted the meal served to be of a good standard and to be adequate in quantity. The Cook said that there continues to be adequate provisions in the Home to enable him to prepare the meals planned on the menu. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) 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 and 20. Service users receive assistance and support in a respectful and appropriate manner. Service users’ physical and emotional health care needs are met. When appropriate, service users are assisted to handle their own medication. Suitable arrangements are in place to enable staff to retain and dispense medication on behalf of service users when this is necessary. EVIDENCE: Service users say that support workers are attentive to their needs without being intrusive. The Inspector witnessed various occasions on which support workers assisted service users. He noted these events to be characterised by a quiet and confident informality which is consistent with good care practice. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 15 Service users who have problems with aspects of their physical health are assisted to seek and to follow the advice of their doctor. Support workers keep a tactful eye open so that medical conditions are noted at an early point. The Inspector has not since the last inspection visit, received any expressions of concern in relation to the Home from members of the local primary health care team. The Registered Manager said that if appropriate service users are assisted to manage their own medication. At the time of the present inspection visit, two of the service users had elected to act in this manner. The Inspector examined selected aspects of the arrangements used by staff to oversee this arrangement and he noted suitable provision to have been made. Members of staff also administer other service users’ medication on their behalf. He found that suitable practices were being used to ensure that service users take them in the manner intended by their doctor. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) 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 and 23. Service users consider that their views are listened to and as necessary are acted upon. Service users are protected from abuse, neglect and self harm. EVIDENCE: Previously the Inspector has established that there is a complaints procedure which explains how service users and other stakeholders can make a complaint about any aspect of the facilities and services provided in the Home. Service users say that they are confident that any matter they raise will receive serious attention and if possible will be addressed. The Inspector notes that since the last inspection visit, the Commission has received an expression of concern about aspects of the arrangements used to support one of the service users when attending an outpatients appointment. The Inspector has reviewed the circumstances involved. He is satisfied that in general the Registered Provider acted appropriately. However, there was one omission. This involved support workers not being able to secure return transport for the service user concerned, because of a lack of petty cash in the The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 17 Home. The Registered Manager said that this oversight has since been corrected. Support workers confirmed this account. Support workers have a good understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances which might jeopardise the well-being of a service user. Also, the Inspector has established previously that they are aware of how to bring such a matter to the attention of the Registered Manager and/or to external regulatory bodies. Service users say that they feel safe living in The Hailey and that they trust all members of staff to act in their best interests. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 18 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) 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, 25, 26, 27, 28, 29 and 30. The Home provides comfortable accommodation. However, some parts of it are specified to a basic standard only. Service users’ bedrooms are adequately presented and equipped. There is a sufficient number of toilets and bathrooms. However, most are not presented to a satisfactory standard. There is adequate equipment in place to enable support workers to assist those service users who experience a measure of reduced mobility. The Home is cleaned to a normal domestic standard. EVIDENCE: The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 19 Service users say that their accommodation is homely and is familiar to them. Previously, the Registered Provider has informed the Inspector that it recognises that the physical standard achieved in various of the bedrooms, in some of the communal areas and in most of the toilets and bathrooms falls below that which service users have the right to expect. The Registered Provider has already addressed a number of the most pressing defects. It has informed the Inspector that the remainder will be addressed as part of a more general programme of refurbishment. Service users say that they like their bedrooms and that they have all they need in order to use them as bed sitting areas. The Inspector had the opportunity to visit two of the bedrooms. He noted them to be comfortable and to reflect the preferences of the person in residence. There is an adequate number of toilets and bathrooms. The Inspector notes that the Registered Provider is considering creating another bathroom on the top floor in the main building. This would be a useful facility for the service users who occupy the bedrooms which are nearby. Although some of the service users are older people, nearly all of the people in residence are able to get about without assistance. There is adequate equipment in place to enable support workers to assist safely those few service users who do experience a measure of reduced mobility. The Registered Manager is aware of the need to keep this matter under review. This is so that additional provision can be made promptly should a service user experience increased difficulties with their mobility. The accommodation is cleaned to a normal domestic standard. The Inspector examined the kitchen and he noted it to be presented to a suitable standard of hygiene and to be operated appropriately. The Inspector understands that the local Department of Environmental Health has not recommended the completion of any improvements which remain outstanding. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 20 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36. Support workers have a good understanding on their duties and they work together well as a team. There is an adequate number of staff on duty. Support workers have the competencies they need and their practice is monitored. Appropriate steps are taken to ensure that only suitable people work in the Home. EVIDENCE: Support workers are provided with a written account of their duties. The staff team is relatively stable. This means that people have got used to working together and that service users know who is going to be around and what they The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 21 are going to be doing. There are handover meetings at the beginning and end of each shift and support workers keep diary records of how things are going for each service user. There are regular staff meetings and support workers say that they are actively consulted by the Registered Manager about how the Home is administered. Routinely, there are three support workers on duty during the day and the evening. They are supplemented by other people who do most of the cleaning or most of the catering. At night time, there are usually three support workers on waking duty. Staff say that enough support workers are deployed in the Home to enable an effective service to be provided. Service users say that support workers are always around when they need them. The Inspector considers the Home to be staffed adequately given the needs for assistance of the service users currently in residence. The Registered Provider is responsible for ensuring that all of the support workers have the competencies necessary to enable them to respond reliably and effectively to the service users’ needs for assistance. The Registered Manager provides introductory training for all new support workers and periodically appraises the competencies of existing staff. The Registered Provider arranges for support workers to undertake specific courses in subjects such as first aid and in how to respond to extreme situations. The Inspector considers the support workers he observed to have the necessary skills and knowledge. All of the support workers meet periodically with the Registered Manager or with the Deputy Manager to review their work. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) 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 and 42. The Registered Manager runs the Home so as to reliably provide service users with appropriate assistance. The Registered Provider operates a quality assurance system. The health and safety of service users and staff is adequately protected. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 23 EVIDENCE: The Registered Manager has the competencies necessary to enable her to operate the Home in the best interests of the service users. She has acquired already one of the two qualifications which the Standards require for incumbents of her role. Now, she has started the necessary course of study which will enable her to obtain the second qualification. The Awards in question are designed to extend and to validate her possession of various competencies which are relevant to the effective management of residential care provision. In addition to this, she has attended various training courses. The Registered Manager has a detailed understanding of the day to operation of the Home and of the particular needs of each of the service users. Both the service users and the members of staff say that they feel themselves to be free to approach the Registered Manager and the Deputy Manager if there is something troubling them. In addition to these informal consultations, the Registered Provider operates a quality assurance system. This is designed to enable stakeholders in general and service users in particular to comment on the adequacy of the facilities and services available in the Home. The Registered Manager is going to strengthen several aspects of how the exercise is undertaken. This will include the preparation of an annual Quality Report. The document will summarise the results of the consultation exercise and it will be available to be reviewed by the service users. The first of these Quality Reports will be made available by 1 September 2006. The Inspector understands that the Kent Fire and Rescue Service has not recommended any improvements which remain outstanding. The Registered Manager is understood to have continued to complete the periodic checks which have to be made to ensure the continued serviceability of the Home’s fire safety regime. However, the Inspector noted there to be several omissions in record of what should be the weekly check of the operability of the fire alarm system. The Registered Manager said that this oversight would be corrected from the date of the inspection visit. The Inspector will check this matter specifically when he next calls to the Home. The Registered Manager said that the Registered Provider has continued to ensure that all appliances such as gas boilers are serviced in accordance with the manufacturers’ instructions. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 24 The Registered Manager said that there are no significant hazards around the premises which could result in someone having an accident. The Inspector did not notice any such hazards. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 25 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT 37 3 38 3 39 2 40 X 41 X 42 3 43 X Standard No 6 7 8 9 10 LIFESTYLES 11 12 13 14 15 16 17 Score 3 3 3 3 X 3 3 3 3 3 3 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 26 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 27 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. The Hailey DS0000058573.V272795.R01.S.doc Version 5.0 Page 28 - 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!