Inspection on 10/04/08 for The Haven

This inspection was carried out on 10th April 2008.

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

Other inspections for this house

The Haven 13/04/07

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 Haven 89 Rock Avenue Gillingham Kent ME7 5PX Lead Inspector Elizabeth Baker Unannounced Inspection 10th April 2008 10:15 The Haven DS0000068801.V361309.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 Haven DS0000068801.V361309.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 Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Haven Address 89 Rock Avenue Gillingham Kent ME7 5PX 01634 570239 F/P 01634 570239 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) Dartford, Gravesham & Swanley Mencap Limited Jennifer Goldstone Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is eight (8) Service users must be between eighteen (18) and sixty five (65) years on admission Service users with a learning disability only to be accommodated. Date of last inspection 13th April 2007 Brief Description of the Service: The Haven provides care and support for seven adults with a mild to severe learning disability. Although the Home has a registration for eight people - it has chosen not to use this as one of the rooms was originally designated as a double room, and in the best interests of the people living in the home all rooms are now allocated as single occupation. Twenty-four hour support is provided. The premises are an older terraced style property and set over four floors. The home does not have a lift. It is close to good local transport networks and is approximately one and a half miles from Gillingham town centre. The home does not have a car park. Parking is on the road and this is limited to either short-term parking or permit holders. The home will provide a day parking permit for visitors. The scale of fees at the time of inspection range from £777.22 to £1,089.00 per week, depending of the level of support required. There are additional charges for chiropody, toiletries, newspapers and hairdressing. Social outings, club admissions and holidays are not included in the core fees. Current activities include Adult Education courses, coastal and shopping trips, discos, social clubs and the library, TV and board games. The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means people who use this service experience adequate quality outcomes. Link inspector Elizabeth Baker carried out the key unannounced visit to the service on 10 April 2008. The visited lasted four hours and consisted of talking with the home manager and a senior care assistant. Unfortunately this visit coincided with the continued temporary closure of the home due to environmental problems, beyond the home’s control. Repair work is taking place and the home is now working to a new completion date. It had been expected the work would have been completed prior to this visit. Because of this not all key standards could be inspected and some were only partially inspected. For judgement purposes adequate has generally been used throughout this report. This will continue until the next site visit to the service when service users have returned and outcomes can be tested in a meaningful way. In support of this visit survey forms and comments had been sent to the service for distribution to residents, healthcare professionals and care managers. At the time of compiling the report no responses had been received. At our request the home manager completed and returned on time the home’s first Annual Quality Assurance Assessment (AQAA). Some of the information gathered from the AQAA has been incorporated into the report. Two service users were interviewed at their day centre. We have not received any complaints about the service. There have been no Safeguarding Adult referrals. What the service does well: The home manager is receptive to advice and suggestions made, and demonstrates an eagerness to rectify any matters, which may require attention. Prior to the disruption of the service there was clear evidence the home manager was working to address some of the requirements and recommendations made following the last visit. Although care records could not be case tracked on this visit, from one available care record, the level of detail on how to support service users is now recorded. This should help care staff in supporting service users in a more meaningful way. The service users interviewed said they like living at the Haven, are being kept informed of the repair progress and want to move back as soon as possible. The Service User Guide and complaints procedure are available in pictorial formats, which should make it easier for some current and future service users to understand. The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Haven DS0000068801.V361309.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 Haven DS0000068801.V361309.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 and 4. Service user outcomes cannot be triangulated to make the judgement other than adequate. This judgement has been made using a range of evidence including a site visit to this service. It was not possible to inspect this standard properly because service users have temporarily moved out the home. However the pre admission information and process assist prospective service users and their advocates in establishing the suitability of this home for their individual assessed needs. EVIDENCE: There have been no new admissions since the last visit. A pictorial and easy to read version of the home’s service user guide has been introduced, making it easier for potential new service users in obtaining a view of the home and its facilities. The home’s AQAA returned to us indicates that relevant professionals and home’s staff initially assess potential new service users in their own homes. Service users have an opportunity to visit the home, usually to have a meal and meet other service users. If this proves successful service users would be invited to stay for a weekend visit. During these periods further assessments are carried out and the opinions of the existing service users are sought. If all parties are happy this usually results in the new service user being admitted. This process should help minimise any anxieties the new service user may have when moving homes. Since the last visit staff have received further The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 9 training in promoting independence, equality and diversity and person centred care. From discussion with available staff it was evident that staff realise the importance of promoting service users’ independence and ensuring corresponding records contain full details of the actual level of support and assistance required to meet the assessed needs of new individual service users. Despite the above we are unable to triangulate evidence of outcomes. The Haven DS0000068801.V361309.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): None. Service user outcomes cannot be triangulated to make the judgement other than adequate. This judgement has been made using a range of evidence including a site visit to this service. It was not possible to inspect this standard properly because service users have temporarily moved out of the home. EVIDENCE: Because of circumstances, current service user files were not available for inspection. The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13 and 14. Service user outcomes cannot be triangulated to make the judgement other than adequate. This judgement has been made using a range of evidence including a site visit to this service. It was not possible to inspect this standard properly because service users have temporarily moved out of the home. Links with the community are in place and support service users’ social and educational opportunities. EVIDENCE: Where possible service users are encouraged to lead independent lives. A number of service users attend an Adult Education Centre, some work as volunteers in charity shops and another is involved in a range of church activities. An interview with a service user highlighted how much they like to go out on shopping trips, including getting items for the home. The service user is also involved in meal preparation and is keen to make cakes and desserts. The service user is currently working through a special programme, which may result in moving from residential care into independent accommodation in a supported living service. Following the use of an advocacy service, advocates had been working with service users to obtain meaningful life histories. However because of the current situation the project The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 12 has not yet been completed. The home manager said obtaining life histories on all residents would continue once all the service users return to the home. To promote diversity and equality the home supports all service users in developing their skills and abilities, including continued learning if that is their wish. To rebuild a particular service user’s confidence up, following a health incident, additional one to one support is now available. For service users with communication impairment, staff have received training in different communication techniques. This should help minimise any frustrations or exclusions the residents may feel. A number of residents like to go to church regularly and one of them is actively involved in church activities. The care record seen contained details of the service user’s cultural and spiritual wishes and preferences. Two service users are able to manage their own finances. Support is provided to the other service users and records are maintained to show how monies have been used. The provider regularly audits the records. Facilities are available to securely maintain any cash or valuables held on service users’ behalf. The provider is actively seeking ways for all service users to have more control of their own finances and allowances. It was suggested that information may be available in our InFocus document In safe keeping – Supporting people who use regulated care services with their finances (May 2007). This is available from our website. Residents are registered with the local council for the purpose of voting in elections. Where they choose to exercise this right they go along to polling stations. Following the change of provider and a review of contracts with sponsoring agencies, the majority of service users are now provided with a sum of money, enabling them to take a holiday. The service should be congratulated on this achievement. Plans have been made for those who wish to take a week’s coach holiday in the summer. Indeed a service user spoken with said how much they were looking forward to this. Despite the above we are unable to triangulate evidence of outcomes. The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): None. Service user outcomes cannot be triangulated to make this judgement other than adequate. This judgement has been made using a range of evidence including a site visit to this service. It was not possible to inspect this standard properly because service users have temporarily moved out of the home. EVIDENCE: Because no service users are actually living at the home at this moment the personal and healthcare support could not be effectively reviewed. It is acknowledged that the home has been working on improving the level of detail in service users’ individual care records and risk assessments to provide a better audit trail of the actual support and care required and that delivered. The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 14 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. Service users who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Service users have access to good information about what to do if they are unhappy about something and know their concerns will be listened to. EVIDENCE: The returned AQAA document indicates the home has not received any complaints about the service in the last 12 months. We have not received any complaints about the service. The member of staff interviewed demonstrated an understanding of safeguarding adult and whistle blowing issues. The two service users spoken with described what they would do if they had any concerns, including talking to the home manager and their care managers. The returned AQAA also indicates that the home has policies and procedures covering bullying and safeguarding adults and the prevention of abuse. Service users are provided with information on how to make a complaint. The document is a combination of pictures, captions and easy to read words. The document provides service users with good information on how and who to speak to if they are concerned about anything. The document includes our contact details. The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 15 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): None. Service user outcomes cannot be triangulated to make the judgement other than adequate. This judgement has been made using a range of evidence including a site visit to this service. It was not possible to inspect this standard properly because service users have temporarily moved out of the home. EVIDENCE: No standards were inspected because of the current situation. However the home has applied to the local council for planning permission to make some environmental improvements to the home. This will include making a separate office, which will allow day rooms to be used as intended by the service users. And a new shower room will be installed. The de-commissioning of the existing one will allow for the laundry facilities to be expanded. More environmental changes are planned. Prior to the incident the home manager had devised a three-year upgrade and improvement plan, which the provider agreed. Funds are in place to achieve this. The proposed changes should enhance the lives of all the service users living at the home. The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 16 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 and 35. Service user outcomes cannot be triangulated to make the judgement other than adequate. This judgement has been made using a range of evidence including a site visit to this service. It was not possible to inspect this standard properly because service users have temporarily moved out of the home. However for service users’ protection, proper systems for recruiting and appointing care staff are in place. EVIDENCE: Normally the home is staffed 24 hours a day. This includes two asleep night staff. Since the last visit, additional one to one support is now available to three service users, assessed as requiring this. This should help the service users in receiving the appropriate level of support. The member of staff interviewed said regular staff meetings take place. No ancillary staff are employed and domestic duties are carried out by care staff and or with input from the service users. The manager has recently had the staffing budget increased and is looking to employ new staff for additional weekday mornings and afternoons, as well as all day at weekends. Training records are kept. These indicated staff had received training on subjects including Learning Disability Qualification awareness, sign-along, managing challenging behaviours, report writing, Mental Capacity Act awareness, Quality Assurance, Epilepsy, equality and diversity and promoting The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 17 independence. The provider is committed to ensuring care staff are trained and skilled to deliver appropriate care and support to service users. Indeed 75 percent of care staff are now trained to NVQ level 2 or above. Two staff files were inspected. These were in good order and provided for an effective audit to be carried out. For service users’ protection, staff are vetted for their suitability of working in a care home. This includes providing references and obtaining Criminal Record Bureau clearance. All new staff work a six-month probationary period. New staff are required to work through an induction programme so their competence can be continually assessed. The induction programme follows the Learning Disability Qualification accredited training, which should provide staff with the appropriate knowledge and skills for the service users living at this home. Despite the above we are unable to fully triangulate evidence of outcomes. The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 18 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. Service user outcomes cannot be triangulated to make the judgement other than adequate. This judgement has been made using a range of evidence including a site visit to this service. It was not possible to inspect this standard properly because service users have temporarily moved out of the home. Despite this the manager has a good understanding of what needs to be done to improve the service and planning is in place to achieve the goals, for the benefit of the service users. EVIDENCE: The home manager has worked at the home for 12 years and has been the manager for five. The manager has successfully achieved the Registered Managers Award. The home manager is anxious for service users to return to the home as soon as possible and is working with the provider and loss adjusters to see this is achieved. The two service users spoken with indicated they wanted to return to the home as soon as possible. Despite the above we are unable to triangulate evidence of outcomes. The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 X 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 3 X X X X X X The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 20 Yes 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 YA6 Regulation 15 Requirement Timescale for action 31/12/08 2. YA6 12 (2) 3. YA9 12 (1) (b) Care plans need to be developed to be more person centred and present a comprehensive portrait of the individual and focussing on positive outcomes for service users. Work has commenced but unable to assess at this visit 31/12/08 The home must evidence that where goals have been identified - they are reviewed with the individual in accordance with the set timescales. Consideration must be given as to how the home will evidence as to how people are supported in achieving these goals. Work has commenced but unable to assess at this visit Assessments need to evidence 31/12/08 that they support service users in being able to make informed choices. Work has commenced but unable to assess at this visit The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 21 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 YA24 Good Practice Recommendations It is recommended that communal spaces are not used as an extension of office areas and that they retain a homely atmosphere. Planning permission has been sought to address the problem It is strongly recommended that the proposed re-allocation of the shower room be addressed so as to protect the privacy of service users using this. Planning permission has been sought to address the problem 2 YA27 The Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone 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 Haven DS0000068801.V361309.R01.S.doc Version 5.2 Page 23 - 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. 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