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Inspection on 26/07/05 for The Island Home

Also see our care home review for The Island Home for more information

This inspection was carried out on 26th July 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Comments about the home, both written and spoken, reflect that the staff team are seen as caring, friendly, respectful and helpful.

What has improved since the last inspection?

The Service User Guide has been reviewed and updated and the Statement of Purpose now contains information about the local difficulties regarding water pressure. The application form for new staff has been improved. Clinical waste is now stored securely and advice has been sought from the local Environmental Health Officer regarding an aspect of hygiene within the home.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE The Island Home Leysdown Road Leysdown Kent ME12 4LH Lead Inspector Christine Lawrence Announced 26 and 27 July 2005 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Island Home Address Leysdown Road Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01795 510271 01795 511747 Dr JS and Mrs KK Pawar Registered Care Home 44 Category(ies) of Older People (23) Physical Disability(20) registration, with number Learning Disability (1) of places H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Residential care for people with a learning disability is restricted to one resident whose date of birth is 26/10/1937 Date of last inspection 3/09/04 Brief Description of the Service: The Island Home is a large purpose adapted, two storey building which is split into two units. The upper floor provides care for twenty four older people. The ground floor provides care for people under 65 who have a physical disability; this is for twenty residents and has been adapted to allow for wheelchair access to all areas. Each area has its own communal areas and bathing facilities. There is a passenger lift. Each floor has its own staff team and in addition to care staff the home also employs catering, domestic, administrative and maintenance staff. There is a first floor patio area as well as large communal gardens. The home is located in the village of Leysdown which has local facilities, and there is a bus service to Sheerness which has more facilities and a railway connection. There is plenty of off road parking available. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection which was undertaken over two days. The inspector spoke to residents and joined those downstairs for lunch. Staff also provided information for this inspection. The inspector spoke to the manager, Sue Strawbridge and to the owner Mrs Pawar. Twenty seven residents completed comment cards and the information they provided was also used as part of this inspection. Six relatives and eight visitors to the home also completed comment cards. The inspector also examined some records and had a look round most of the building. What the service does well: 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. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 3 Prospective residents and/or their representatives have the information they need to decide if the home is right for them. Residents’ needs and aspirations are assessed before admission. EVIDENCE: The Statement of Purpose and the Service User Guide have been reviewed and updated to ensure that they have all the relevant information. Individual records for residents upstairs and downstairs were looked at during this inspection. The Resident Assessment Form is used to identify care needs. This form contains a range of information and is used to compile a care plan. There was also evidence of information being obtained from placing authorities. The assessment form indicates the equivalent area within the care plan for ease of cross-referencing. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service Users, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Residents’ health, personal and social care needs are set out in an individual plan which reflects changing needs. Residents are protected by the home’s procedures regarding medication. Residents’ rights to privacy and respect are upheld. EVIDENCE: The care plans viewed for this inspection contain relevant information based on the initial assessments. There are clear guidelines for staff about how care should be provided. There is a format used to identify if any changes have H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 9 been made to the care plan and there is a section for risk assessments. The areas relating to health care needs clearly reflect the sometimes very individual needs of residents. Health care professionals are involved where necessary and evidence was seen of residents being supported to attend hospital appointments. Medication is appropriately stored and the record of administration was properly noted. Staff members who give out medication have received training. If someone wishes to self-medicate a risk assessment is completed. Examples were noted of residents’ preference for how they wish to be called being respected. Mail is passed to residents to open but staff will help and support if required. Twenty four residents said in the comment cards they completed for this inspection, that their privacy was respected. Staff spoken to confirmed that privacy and dignity were an important part of providing care and support to residents at the home. One resident said staff were “…very helpful, respectful and dignity and privacy were there all the time…”. Screening is provided within shared rooms. Residents spoken to during this inspection felt that staff listened to what was important to them. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service Users have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with asssistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents have opportunities for appropriate activities and they are able to make choices about their daily routines. Residents are supported to maintain contact with friends and family. Meals are appealing and nutritious and mealtimes are relaxed. EVIDENCE: Most residents were positive in their comments about activities but three people would like more games of indoor bowls or skittles. Both records and comments from residents reflected that as much opportunity as possible is given to residents to make choices about how they lead their lives and what H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 11 their daily routines are. Some residents attend church locally when they wish. Service users described activities and past times that would involve them in the local community. Shopping trips, walks, meals out and use of local amenities and services were all included in the activities mentioned. Many of the people working in the home live on the Island and bring with them knowledge of the area. One care manger included in the comment card “…service user able to get out on a regular basis with the support of staff…”. There are no restrictions on visiting times at the home and of the eight relatives who completed comment cards for this inspection all said they were welcomed in the home by staff. One person made the point of saying “…very welcome…”. The inspector joined some residents for lunch. The meal was tasty and staff clearly knew individuals’ preferences. In the comment cards completed by residents 25 said that they liked the food. Verbal comments included “…the food is good and there’s plenty of it…”. The atmosphere was relaxed. There were examples of residents choosing to eat on their own and one person prefers to have a cooked meal in the evening, which is catered for. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service Users feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents and their representatives can be confident that their complaints will be listened to and taken seriously. EVIDENCE: There is a complaints procedure within the home which includes a commitment to respond to any complainant within 28 days and also has information about how to contact the Commission for Social Care Inspection. There have been no complaints in the last 12 months. One relative said in their comment card “…it’s encouraged to discuss things you’re worried about…”. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 Residents live in a safe, well-maintained environment which is clean and hygienic. EVIDENCE: The location of the home is suitable for its stated purpose. It is well maintained and there is a handyman employed. The individual and communal rooms are furnished and decorated in a satisfactory way. There is an accessible garden and a roof terrace for residents on the first floor. There are no outstanding requirements from the fire safety officer or the local authority H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 14 environmental health officer. A CCTV camera is in use, but only to monitor visitors at the front door. The home was clean at the time of the inspection and there were no offensive odours. The laundry is small but the washing machine is modern with a ‘disinfection with sluice’ cycle. Two part time cleaners are employed and there are appropriate policies and procedures in place. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Residents’ needs are met by staff who are experienced and qualified. Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: Twenty five of the residents who completed comment cards said that they felt well cared for and staff treated them well. Relatives’ comments included “…the staff are always very kind and caring…it’s peace of mind for me knowing he’s safe…” “…the staff go out of their way to help…”. Visiting professionals’ comments included “…always found staff to be friendly and helpful. Care of residents always found to be good…” “…good, friendly standard of care…” “…caring and compassionate nature…”. The two floors are staffed separately and there is a designated deputy manager for each floor. The rota seen indicates that staffing levels are adequate and only five people have left employment in the past ten months. A lot of staff have worked at the home for many years. The staff team are a mixture of ages, experience and qualifications. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 16 Seven staff have completed assessments for national vocational qualification in care (level 2) and five are currently undergoing this process. Three staff members have completed level 3 and three senior members of staff are undertaking level 4. There is a rolling programme of training which encompasses induction and ongoing. Two staff members showed the inspector their portfolios which are used to record training. Staff records seen show that the home has appropriate procedures which include the use of application forms, interviews (and an interview checklist) and two written references. The application form gives prospective staff information about the Data Protection Act and the application process includes equal opportunities monitoring and a pre-employment questionnaire relating to health. Staff are given written terms and conditions of employment as well as copies of the General Social Care Council’s code. Criminal record bureau checks are carried out on new members of staff. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s polies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 33, 35 and 38 (Older People) and Standards 23, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The health and safety of residents and staff are promoted and protected H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 18 EVIDENCE: Training relating to health and safety forms part of the ongoing programme. Policies and procedures available to staff include Control of Substances Hazardous to Health (COSHH) Regulations, disposal of clinical waste, fire safety, first aid, health and safety, food safety, moving and handling and infection control. A spot check on maintenance and service agreements indicated that these are appropriate and up to date. Fire safety checks are regularly carried out. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 x 5 x 6 x HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 3 x x x x x x 3 Score Standard No 7 8 9 10 11 Score 3 3 3 3 x Standard No 27 28 29 30 3 3 3 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score 3 x x MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 x 33 x 34 x 35 x 36 x 37 x 38 3 H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement None at this time Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations None at this time H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 21 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. H56-H05 S24028 The Island Home V230395 260705 Stage 2.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!