Inspection on 13/04/07 for The Haven

This inspection was carried out on 13th April 2007.

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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Haven 10/04/08

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 Anne Butts Key Unannounced Inspection 13th April 2007 10:00 The Haven DS0000068801.V335488.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.V335488.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.V335488.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.V335488.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users must be between eighteen (18) and sixty five (65) years on admission Service users with a learning disability only to be accommodated. This is the first inspection for this home following a new provider taking . Date of last inspection 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, and therefore is not suitable for people with limited mobility. It is close to good local transport networks and is approximately 1½ miles from Gillingham town centre. 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 £290.00 - £416.00. There are additional charges for chiropody, toiletries and hairdressing. Social outings and holidays are not included in the fees. The Haven DS0000068801.V335488.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 and the first for The Haven since Dartford, Gravesham and Swanley (DGS) Mencap have taken over the role as Registered Provider. The actual site visit took place over two days – the first day consisted of visiting the home and reviewing records, talking to people living in the home and staff who were on duty at the time. The second part of the visit was to give ‘feedback’ to the Manager and to further discuss any areas that needed clarification. Further information was obtained through questionnaires sent out to stakeholders, commissioners of the service, relatives and associated professionals. What the service does well: What has improved since the last inspection? There is a new provider organisation in place, Dartford, Gravesham and Swanley (DGS) Mencap who are supporting the manager and staff on a regular basis. There is a new needs assessment in place that covers different areas of need satisfactorily, although some of the detail contained within this was seen to be sparse and contradictory. Service users are now being supported by an Advocacy service. Two service users have benefited from travel training, which has increased their independence. A mini-bus has been purchased and this is enabling people in the home to access more outside activities and go out on trips and excursions. The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 6 Overall training has improved, although the people living in the home would further benefit if staff are trained in meeting any specialist needs. 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.V335488.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.V335488.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): 2, 3, and 4. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users and their families benefit from having the opportunity to visit the home prior to moving in and the assessment process meets their needs adequately. However people would benefit from this process being more indepth in order to fully meet individual needs. EVIDENCE: There are currently six service users living in the home, and there have been no new service users admitted since DGS Mencap took responsibility for the running of the home. There is an updated Service Users Guide available which incorporates the Statement of Purpose. A copy of this was presented to the Commission for Social Care Inspection (CSCI) on registration. Although there have been no new service users in the home, at the time of this visit the home was currently going through a process to accommodate a new person into the service. The Senior member of staff on duty at the time was able to fully describe the procedure that was taking place and this included an introductory visit that enabled the person to come into the home and meet the people already living there. Plans were also in place for an over night stay and The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 9 this was being carried out with the agreement of the individual involved and the Care Manager who was arranging this. There is a new assessment process in place and all current service users have had their needs re-assessed in accordance with this. This contains a Pen Portrait – which is a descriptive overview of their needs and the further assessment process then covers a range of needs including health and personal care, psychological well-being, communication, personal and social skills, financial support, cultural needs, employment and/or educational needs amongst others. From this further records are developed to support people with their assessed needs. DGS Mencap has demonstrated that they are supporting staff with accessing training programmes and staff spoken with on the day of inspection did show an awareness of how to provide overall support to the people living in the Home. However some members of staff appeared unsure as to exactly how to support individual people with improving and maintaining their self-esteem and further promoting their independence. Although training has greatly improved, records did not demonstrate that staff have benefited from undergoing training with regard to specialist needs of people with learning disabilities. The Haven DS0000068801.V335488.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, 8, 9 and 10. 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 and benefit from having an active role in the home. However individual changing and ongoing needs could be better reflected in care plans and risk assessments that would support people to meet individual goals EVIDENCE: The new assessment documentation that has been implemented and been updated for all service users in the home did not fully explore individual needs and the detail was seen to be sparse in the information that it contained. The ‘Pen Portrait’ in the care plans viewed was seen to be contradictory of information contained within the needs assessment and it was difficult to ascertain as to exactly what the individual needs of the service users are. For example where under in the assessment process it identifies there are no support needs required – the ‘Pen Portrait’ then stated that there were some needs in a particular area. This is not promoting the continuity of support and The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 11 clarity of staff roles – this must addressed so that individuals can be confident that their individual needs are being met appropriately. Following on from the ‘Pen Portrait’ and the assessment process the home has implemented a set of records that demonstrate as to how they are considering individual strengths, further aspirations and then individual goals. However, as identified within the assessment process there are inconsistencies, and it was not possible to evidence that the information would allow staff to fully support the people living in the home. The care plan does not present itself as a working document and does not consistently reflect the care being provided. Although there was some evidence that people living in the home had participated in setting out their goals, the supporting assessment process did not show individual participation. The organisation has promoted an Advocacy Service, and they are currently working with the people in the Home to implement an individual plan for each person – although there was no evidence at the time of this visit as to how far this has progressed. Conversations were held with people who live in the Home and everyone spoken with were able to speak positively about their daily lives. Comments included “I like it here”, “I can go to college and I can always watch television when I want”, “I like living here – it’s really nice”. People living in the home have a choice about their daily living activities and regular meetings are held with service users. People living in the home discussed their activities and were able to describe their involvement in the day-to-day running of the home. The risk taking systems in the Home appear to be ‘stilted’ – in that they do not support the people living here to be able to take responsible risks. The Home can recognise where there are concerns or areas of risk – but there are limited pro-active measures in place that evidence the promotion of the development of the individual. Conversations with members of staff, the manager and a review of records in the home did show that on a daily basis everyone is well supported and that they are able to manage daily living activities in the preferred interests of the individuals. However, the records did not evidence how identified needs and aspirations could be met through personal futures planning for the individual. Discussions with the manager evidenced that there had been no training provided in writing care plans or carrying out risk assessments – it is being strongly recommended that staff are trained in person centred planning techniques. There is a policy and procedure in place for confidentiality and the majority of records were kept in a locked cupboard. There were some day records that were kept in an unsecured location and were available for anyone to view – discussions were held around this at the time of the visit and the manager arranged for these to be placed in the locked cupboard immediately. The Haven DS0000068801.V335488.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): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from support and care in their daily living routine that is flexible to suit their needs and preferences. Individual lifestyles could be further enhanced by the development of opportunities to achieve individual goals. EVIDENCE: As described earlier in this report staff are very supportive of service users and ensuring that they acknowledge and promote their daily living needs. Two service users have benefited from personal ‘travel training’ – this has enabled them to access additional outside activities. In one case this has allowed a service user to achieve his goal in developing his skills in the hobby of his choice. The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 13 All service users living in the home access a range of outside activities that supports them with educational and occupational skills. Conversations with individual people demonstrated that they accessed different courses at college and also worked in local charity shops. People are also encouraged to participate in activities around the home. Three service users described how they enjoyed gardening and growing seeds and bulbs in the summer and another discussed his hobbies, which included making cards. People tend to spend time at home in the evenings watching television or videos. The larger organisation, however, has recently purchased a mini-bus for the use of the home, and this has already enabled service users to be able to go out and about more. Service users described a visit to the coast, where they had a fish and chip supper. Comments included “It made a nice change – I really enjoyed it” and “It was good – I liked visiting somewhere different”. A picnic had also been arranged for the weekend. The mini-bus is also being used to take people out shopping and on the day of the inspection all service users were going to the supermarket to buy groceries for the week. Service users are also encouraged to take part in household activities including general cleaning, going shopping and helping to prepare meals. Individual goals for some of the service users have been developed and met. However, not all service users were benefiting from this and the home needs to take into account all identified needs and further develop the individual plans and agreed pro-active ways of meeting these needs The rapport between staff and people living in the home was observed to be relaxed and the interaction positive – with staff working with the individual people and supporting them in daily tasks. Mealtimes are arranged in the home with the people living there and are flexible. As a lot of the people are out and about during the day, lunchtimes tend to be on an ‘as and when’ basis that suits each individual and staff support them in making the lunch of their choice. Evening meals are more of a social occasion with people tending to sit down together. Overall menus showed that there are a variety of different meals and all service users spoken to on the day of the visit confirmed that they enjoyed their meals. It was noted, however, that two service users had some further particular needs with regards to their diet identified within their care plans, but there was no evidence that the home was working with the service users to make sure that they were being fully supported with this. The Haven DS0000068801.V335488.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. Service users are well supported on a daily basis with their personal and healthcare needs, however their individual emotional wellbeing and development would be further enhanced by promoting the development of individual skills. EVIDENCE: The people living in the home are able to manage their own personal care and are given the personal support they need to maximise their independence. The home supports people with access to healthcare professionals. Records showed that they are supported with appointments such as visiting the GP. Records did not fully evidence regular visits to the dentist and optician and the home must ensure that they support service users in accessing these facilities or that accurate records are maintained with regards to this. It was identified that some specialist healthcare support had been accessed for one individual, but the recommendations from this were not being followed. The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 15 The speech and language therapist had assessed this person and dietary advice had been given. Records of menus did not show that the individual was being supported with this assessed need. Discussions with the manager demonstrated that the person did not wish to follow this advice – but there were no records to support this or any evidence of further advice or agreed ways of supporting the individual with their choices. Another service user had also undergone some healthcare tests and the home was waiting for the results. This had been identified as a goal for this person and the outcome would guide as to how the home could offer further support. The home had agreed a timescale with the person, however the agreed timescale had long passed and the results had not yet been received and no further action had been taken. It is acknowledged that the home is dependent upon the hospital, however they do need to evidence that they work with the individual in ‘chasing up’ the outcome of these results, as in the meantime the individual is not benefiting from as good a quality of life as they could reasonably expect. There were references within some of the care plans and daily records to some behavioural changes in mood and general well-being. There was no evidence within these records as to how the home worked with service users in addressing and managing any changes in moods or identifying possible triggers that could affect the individual. The service users have lived in the home for many years and the majority of the staff are long-serving members of the staff – there is a risk that people have become over-familiar and complacent with the way of life within the home and, therefore, when faced with any form of challenging situation there are re-active strategies in place as opposed to positive and pro-active measures that would further support individual people. So although the manager and staff demonstrated a good understanding of daily behaviour there is a need to move positively forward with supporting people. There is a medication policy and procedure in place, and the home has taken steps to work with service users in supporting them in managing their own medication if they so wished. Records showed of the service users who were supported with their medication – they preferred not to manage their own. The Haven DS0000068801.V335488.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. The home has a clear and effective complaints system in place and people are protected by robust adult protection policies and procedures. EVIDENCE: There is an updated complaints procedure in place, and this is in a format that is suitable for the service users living in the home. There are clear guidelines on how to make on complaint and on whom to. The complaints procedure is available for all service users or their families. All the people living in the home who were spoken to on the day of the visit confirmed that they were happy to speak to any members of staff if they had any problems or concerns. Since the previous inspection the home had been through an Adult Protection investigation, this has resulted in some changes being made within the home especially with regards to the daily records. The manager was able to demonstrate a good understanding of the procedures involved. Staff files viewed all evidenced that staff had undergone Adult Protection training. The home is very aware of the need to protect service users and the new provider organisation has been very supportive of staff within the home. Records viewed also evidenced that staff are in receipt of satisfactory Criminal Records Bureau (CRB) checks and Protection of Vulnerable Adults (POVA) checks had been undertaken. The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 17 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, 27 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst overall the communal areas are comfortable the home needs to be refurbished for the benefit of the service users and retain a homely impression. Service users do not benefit from having access to shower facilities that promote their privacy and dignity. EVIDENCE: The home is set out over three floors plus a large basement and is in the style of a Victorian terraced property. Over the years very little money has been spent on the upkeep of the environment and, although, the home is clean and has been reasonably maintained the décor, carpeting and furnishings are showing signs of wear and tear. DGS Mencap had identified that there was some urgent works that needed carrying out in the home. It was disappointing to see, therefore, that limited The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 18 improvement works had taken place. It is appreciated that DGS Mencap do not yet own the actual building and negotiations are still ongoing with regards to this, however in line with their own observations there are some priority works that do need to be considered in the near future. DGS Mencap had identified that the downstairs shower was not appropriately situated as access was through the kitchen/diner area and indeed on this visit a service user was observed walking through the home in their dressing gown to take a shower. They had also identified that other areas needed addressing such as the flooring in the upstairs bathroom and the laundry area, as well as a redecoration and refurbishment. Reports from the registered provider, conversations with the service users and staff also evidenced that the discussions had taken place about the proposed improvements, and the people living in the home were looking forward to this. The dining area in the kitchen has at least two large notice boards up with a substantial amount of paperwork pinned on them. There is also now a large photocopier in this area. These give the impression that this is part of an extended office and does detract from a homely environment in which the service users can cook and eat their meals. It is being strongly recommended that this be reviewed. Individual bedrooms were not viewed at this visit. The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 19 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): 31, 32, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users benefit from being cared for by staff that have a good basic understanding of their needs, however their support may be compromised as staff have not received adequate training in some of the specialist needs of this service user group. EVIDENCE: The home currently employs seven members of staff, including the manager and a senior, with two members of staff being on duty at any one time. As the people living in the home are primarily independent with their daily living support and there are currently six people in the home, this does not appear to be having an immediate adverse affect on the daily support provided. As identified throughout this report, however, any support that may be needed to assist people with achieving individual goals and/or aspirations are limited and a factor in this is the current staffing levels. There are sufficient staff on duty, although the levels do not enable staff to be able to support individuals with any different choices, and although the provision of the minibus has The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 20 enabled group outings, the home is unable to sustain and support individuals with any individual choices or identified needs. Records viewed and conversations with the manager staff evidenced that staff training has improved with a training programme being rolled out to all staff. Training undertaken includes Health & Safety, 1st Aid, Manual Handling, Adult Protection, Infection Control and food hygiene. The Manager will also be undertaking her NVQ 4 and the Senior Care Worker has an NVQ3 and will be taking the NVQ assessors award. Not all staff have benefited from the training although there is a programme in place for this. Although some staff had taken some service user specific training such as Epilepsy Awareness and Managing Challenging Behaviour, the mandatory training programme for the organisation does not, however, include specialist training in meeting the needs of the client group the home supports. It is being strongly recommended that staff are trained in the specific conditions of service users and in skills on how to meet individual needs such as communication skills and managing challenging behaviours. There have been no new members of staff recruited since DGS Mencap took over, although they are currently looking to recruit an additional Senior plus additional part-time staff. The Manager confirmed that the Human Resources department is now managing recruitment and her only involvement was through the interview process –this standard was not inspected on this occasion. During the course of the visit observation showed that staff related well with service users and people who live in the home spoke positively of the carers. Staff spoken with all confirmed that they felt well supported and that training opportunities had improved. The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 21 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. Whilst service users can be confident that they are cared for by a manager and staff who are committed to promoting their general wellbeing, people are not benefiting from having the opportunity to develop their skills and independence. EVIDENCE: There is a Registered Manager in place who has worked for the home for a number of years. She has obtained her Registered Managers Award and will be starting her NVQ level 4 qualification. The area manager for DGS Mencap who makes regular visits to the home is supporting the management of the home. The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 22 The people living in the home described how they had regular meetings and were able to discuss menus, outings and things that concerned them. DGS Mencap are also undertaking regular visits and from these are identifying areas of the home that need attention. Staff confirmed that plans have been drawn up for improvements, although no further action has been taken as yet no further action had been taken. There was no evidence that as yet there is a full quality review system in place, although it is early days for the new provider. Observations showed that there are safe working practices in place; staff were able to demonstrate a knowledge of general health and safety issues. Food hygiene practices were observed to be met. There are systems in place to help prevent the spread of infection and liquid soap and paper towels are available at hand-washing facilities. All cleaning materials were seen to be locked securely away. The manager and staff aim to make sure that the home is run in the best interests of the people living there, and are supportive and able to meet their daily ongoing needs. The Statement of Purpose states, “A significant emphasis is place on the development of independent skills”. Evidence gained throughout the course of the visit did demonstrate, however, that the people living in the home are not benefiting from support that will help them to achieve their full potential. Where people have been identified through either a G.P. or care assessment that they have lost skills or confidence or need support in recognising their individual skill levels - no recorded evidence was available to support as to how the home is addressing these needs. The manager did acknowledge that the current funding did not allow for high levels of one-to-one support and also accepted that some of the support needs for the development of individuals was not evidenced in the care plans and assessments. She resolved to start addressing these issues immediately following the inspection. The home must, however, ensure that individual people are receiving the correct level of support and must access appropriate professionals or take further advice to support them in this if necessary. The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 23 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 X 2 2 3 2 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 2 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 2 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 3 2 X LIFESTYLES Standard No Score 11 2 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 2 X X 3 X The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 31/07/07 2. YA6 12 (2) 3 YA9 12 (1) (b) 4 YA19 13 (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. The home must evidence that 31/07/07 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. Assessments need to evidence 31/07/07 that they support service users in being able to make informed choices. The home must ensure that 31/07/07 where individuals have been assessed in having specialist healthcare needs that they are working with the person in supporting them in managing their health and welfare appropriately. The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 25 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 2 3 4 5 Refer to Standard YA3 YA6 YA19 YA24 Good Practice Recommendations Staff should be trained in any specialist needs of the service users. It is strongly recommended that the manager and staff are trained in person centred planning techniques. Records must evidence that service users have regular access to healthcare services such as dentist and optician. It is recommended that communal spaces are not used as an extension of office areas and that they retain a homely atmosphere. It is strongly recommended that the proposed re-allocation of the shower room is addressed so as to protect the privacy of service users using this. YA27 The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Haven DS0000068801.V335488.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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