Inspection on 07/11/06 for The Homesteads

This inspection was carried out on 7th November 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 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Homesteads 23/11/07

The Homesteads 08/08/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Homesteads (The) 216 Southend Road Stanford Le Hope Essex SS17 7AQ Lead Inspector Ann Davey Unannounced Inspection 7th November 2006 09.00 Homesteads (The) DS0000060828.V317787.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 Homesteads (The) DS0000060828.V317787.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. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homesteads (The) Address 216 Southend Road Stanford Le Hope Essex SS17 7AQ 01375 402444 01375 401937 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) Mr Steven Monaghan Mr John Charles O’Connor Ms Janice Tyrrell Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th October 2005 Brief Description of the Service: The Homesteads is a corner plot establishment on the main Stanford le Hope road. The home provides personal care for 6 young adults with a learning disability. It is situated within a reasonable distance of local facilities and there is a bus stop outside the home. The home has 2 floors and provides 6 single bedroom ensuite facilities. There is a reasonably sized patio/garden area to the rear of the property. The range of fees was provided by the manager as being £684.29 - £926.09 per week. There are additional charges for toiletries and items of a personal nature. A current copy of the home’s Statement of Purpose is available upon request. All residents are provided with a ‘user friendly’ Service User’s Guide, and additional copies are available upon request. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection site visit. The inspection was undertaken over a seven hour period. At this inspection, all the key standards (plus others as appropriate) were assessed as was the progress the home had made since the last inspection. A partial tour of the home took place. Staff, residents and a relative were spoken with. A random selection of records was selected and viewed, care practice was observed. The majority of the residents living in the home were around for part, if not all of the day. The home was warm, friendly and full of various interactions and activity. In preparation for the visit, the Commission had sent out questionnaires, but unfortunately there had not been a good response. However, as part of the homes internal quality assurance process, the manager had sent out their own questionnaires and the response was very positive, not only in terms of the number completed and returned, but also by the remarks made. These views and opinions have been incorporated within this report. Some residents at The Homesteads have complex care needs and therefore were unable to express views and opinions about the home or how it is to live there. However, those able to express a view were very positive and through direct observation, all residents appeared relaxed and happy. Staff interacted well with residents and were very aware of individual needs. A relative of one resident who phoned during the inspection was very positive about the caring and supportive approach not only to residents, but also to them as a family. What the service does well: What has improved since the last inspection? Since the last inspection, the home has improved on a number of levels. There is now a stable core staff group, the home is more established and the recording/documentation systems are now in good order. During the Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 6 inspection, there was a positive feeling of good management and structure. The inspector was very encouraged with these findings. The home is committed to maintain these standards. 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. Homesteads (The) DS0000060828.V317787.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 Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home was readily available and in a ‘user friendly’ format. Residents, families and other interested parties are fully involved in the admission process and appropriate assessments had been carried out. EVIDENCE: A current Statement of Purpose was available and all residents are provided with a ‘user friendly’ Service User’s Guide. Copies of both documents are available upon request. The case record of the most recent admission to the home was viewed. Full pre admission assessments were evident and records showed that the resident had visited the home on several occasions before admission had taken place. The new resident’s views, opinions and expectations had been noted and recorded. Records were in good order. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning process within the home is detailed, comprehensive, orderly and provides a sound basis for the provision of good care. EVIDENCE: Three sets of care plan documentation and associated records were selected at random and viewed. The recording system itself was very orderly, information was current and handwriting was clear. Resident’s views, opinions and expectations were clearly recorded, as well as those of relatives and other associated professionals. Documentation demonstrated that residents (according to ability) fully participate in the planning of their own care. Risk assessments were current and detailed. It was evident that regular reviews take place. The home has an established key worker system. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 10 Records relating to residents personal monies being held by the home were viewed at random. Records were in good order. Feedback from relatives and other professionals about the care provided by the home was very positive. Staff spoken with had a good understanding of residents care, emotional, health and social needs. Those residents spoken with and able to express a view were happy within the home. From observation during the day, residents appeared settled, content and expressed their happiness and pleasure in a variety of ways. Homesteads (The) DS0000060828.V317787.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): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are actively encouraged and enabled to lead a full and meaningful lifestyle. The home has a good understanding of individual resident’s food preferences and appropriate records are kept. EVIDENCE: Each resident participates in the planning of their own individual structured daily activity programme. The home has good established links with local colleges and adult learning centres. Residents also attended a variety of day centres, social clubs and community events. All residents have the opportunity to enjoy and participate in a wide variety of social and recreational activities which include swimming lessons and horse riding. The home has recently ‘adopted’ a horse which lives in a nearby sanctuary. This has proved to be very popular going by the number of pictures of the horse which are around the home. The talents of individual residents are recognised and encouraged and Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 12 the results are tastefully displayed throughout the home. The home organises group summer holidays and has its own transport. During the course of the day, residents were ‘going and coming’ and when spoken with, expressed pleasure about what they had been occupied in or where they had been. The home is currently re-sitting a designated visitors area in which residents will be able to meet and talk with their visitors in private. A relative who visits the home on a regular basis said that they were very happy to visit and would ‘love to move in’. Records demonstrated that residents are fully involved in the planning of daily meals. In addition, according to ability, all residents assist with the shopping and in the preparation of food. Detailed records were available demonstrating that residents are provided with a varied and nutritional diet. Homesteads (The) DS0000060828.V317787.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): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home had a good understanding of individual resident’s personal and health care needs. EVIDENCE: Individual resident’s care plan documentation details the personal and health supports needs required. It then go on to say who these needs are going to be met and who by. Some resident’s have complex care needs, but documentation but was comprehensive and current. The home said that they have a good working relationship with the local GP practice and find that the support they get from the surgery is very good. Records demonstrate that where appropriate other health care professionals are consulted. Resident’s individual preferences, likes and dislikes are recorded and incorporated into care plan documentation. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 14 The home uses a monthly dispensed monitored dosage system of medication administration (Mandrax). Staff are trained in safe practices relating to medication administration. The storage of medication and was tidy and in good order as were associated records. The home has an established system whereby residents can take their prescribed medication during the day whilst they are on holiday, day centres etc. It was noted that some medication is prescribed at PRN (as/when necessary), but there were no administration protocols in place. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear complaints process in place. A relative spoken with was aware of how to make a complaint. Residents are protected from abuse by staff knowledge and their subsequent actions. EVIDENCE: The home has a complaints procedure in place and a relative spoken with was aware of how to make a complaint. In addition, residents have their own ‘user friendly’ complaints procedure displayed in the home. The home has not received any complaints since the last inspection. Staff training records showed that staff have received training in the protection of vulnerable adults. Staff spoken with had a good understanding of what would be expected of them should abuse be expected. The home was able to demonstrate that there was a good supply of information/documentation about adult abuse. However, the home must ensure that the information available to staff for reference is current. One publication about adult abuse procedures was outdated. This was rectified by the manager. The home is aware of the importance of establishing links with an advocacy service if considered necessary, and a poster in the office is displayed with the details. However, all current residents have established links with other care professionals and/or relatives on a regular basis. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 16 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): 24,26 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and homely environment that meets their needs. All residents have their own rooms with ensuite facilities and there are sufficient shared communal spaces. EVIDENCE: Each resident has their own bedroom which is of sufficient size to meet their needs. All have ensuite facilities. Not all bedrooms were seen, but those which were viewed, were homely, comfortable, clean and very personalised. At present, there is a communal bathroom on each floor, a ground floor designated visitors room, 2 lounge/dining areas, kitchen and office and a 1st floor staff sleeping in room and a laundry room, At the time of the inspection an application was being processed by the Commission to increase the registration numbers by two. Within the application, some of these facilities Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 17 may change location or designation. Further discussions are taking place about this matter. The communal areas within the home were well furnished and comfortable. The laundry and kitchen areas were clean and orderly. At the time of the inspection, the rear garden area was being cleared and tidied up. The décor and furnishings within the home create a warm, friendly and homely atmosphere. No obvious safety hazards were seen. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a stable group of staff who understand the needs of residents. EVIDENCE: The home now has a stable group of staff who understood current residents needs. Staff spoken with demonstrated commitment to providing a good quality of care to residents. The staff rota was accurate and there were adequate staff on duty to meet current residents assessed care needs. As part of the application to increase registration numbers by two, the home is committed to providing an extra member of staff on duty during the day shift. Staff training records were in order and the home was able to demonstrate that regular staff supervision sessions take place. Staff spoke of regular team meetings. The records of the most recently recruited member of staff was viewed. Records were in good order and there was a record of an induction period. Another fairly new member of staff was also spoken with and said that the Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 19 recruitment process had been thorough and appreciated the continuing support of more senior staff. Staff on duty spoke of a good team spirit. The home employs staff with a diversity of skill, expertise and experience. This had created a good staff skill mix which is evident in creative, social, care practice and administration tasks undertaken within the home. From observation, staff and residents related well to each other. There was a good sense of natural rapport and good humour around the home. One relative spoke very positively about staff in the home. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 20 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): 37,38,39 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents benefit form the leadership and management approach of the home. The home is managed safely with appropriate safety and maintenance checks being carried out. Quality assurance processes need drawing together in order to identity areas for possible improvement. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 21 EVIDENCE: Since the last inspection, the home has established itself and now presents as a well managed home. There was a sense of good order about the home. The manager and the deputy manager were confident and competent about their respective roles and responsibilities. It was also good to meet up the both the registered providers during the day. The home has been very active in sending out their own quality assurance questionnaires and have received some very positive responses. However, the home should now work towards producing an ‘Annual Development Plan’ as required by Regulation 24. Residents are actively encouraged to be involved in every aspect of the way the home is managed and run. This includes an identified resident representing the home on a community committee and whilst another resident participates in new staff recruitment interviews. Established systems are in place to ensure that residents’ views and opinions help to shape the future plans and ideas for the home. A random selection of safety and maintenance records were viewed and found to be in good order. These included a gas safety inspection record dated 18/1/06, a Portable Appliance (electrical) Test dated 25/1/06 and a Fire Alarm maintenance checked dated 27/2/06. The home tests the fire ‘break glass weekly and the emergency lighting system monthly. There were no records to demonstrated that the fire fighting equipment is checked to make sure that it hasn’t been discharged, damaged or moved. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 22 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 3 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 3 25 X 26 3 27 X 28 X 29 X 30 3 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 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 3 X X 3 x Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 23 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 YA20 Regulation 13 Requirement The registered person(s) must make appropriate arrangements for the safe handling and administration of medication within the home. This is with reference to adequate records being held in respect of PRN (as/when required) medication. Timescale for action 15/12/06 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 Refer to Standard YA39 YA42 Good Practice Recommendations The registered person(s) should make arrangements to produce an Annual Development Plan in accordance with Regulation 24. The registered person(s) should make arrangements to ensure that all fire fighting equipment in the home is regularly checked to make sure that it has not been discharged, damaged or moved. Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Homesteads (The) DS0000060828.V317787.R01.S.doc Version 5.2 Page 25 - 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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