Inspection on 16/09/08 for The Laurels

This inspection was carried out on 16th September 2008.

CSCI found this care home to be providing an Excellent service.

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

Other inspections for this house

The Laurels 19/09/06

The Laurels 25/10/05

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Laurels 209 Faversham Road Kennington Ashford Kent TN24 9AF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Paul Stibbons     Date: 1 6 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: The Laurels 209 Faversham Road Kennington Ashford Kent TN24 9AF 01233635932 Telephone number: Fax number: Email address: Provider web address: annapage@btinternet.com Name of registered provider(s): Name of registered manager (if applicable) Ms Anna Elizabeth Page Type of registration: Number of places registered: CareTech Community Services (No.2) Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home The Laurels cares for 5 people with mental health problems and 1 person with a learning disability. The home is a detached house on two floors, with a large usable garden. Residents have their own bedrooms and there is a bathroom on each floor. It is situated in a residential area on the outskirts of Ashford, and within easy travelling distance of local amenities such as health centres, shops, churches, pubs, clubs, Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 6 Brief description of the care home colleges, a cinema, library and bowling alley. The home has access to all necessary healthcare services within the community. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place on the 16th September 2008 over a period of four hours and thirty minutes and was the first key inspection since 19th September 2006. A completed AQAA (Annual Quality Assurance Assessment) had been completed by the service and returned to the commission prior to this visit. A tour of the premises was carried out and a variety of documents and records were examined. The inspector held discussions with the management, staff members and residents during the visit. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have sufficient information on which to base an informed decision as to whether the home can meet their needs. A comprehensive assessment of needs is carried out prior to admission to ensure the home can meet prospective residents needs. People living in the home have the security of an individual written contract of terms and conditions attached to the placement. Evidence: The home provides a statement of purpose that is specific to the individual home and the resident group they care for. It clearly sets out the objectives and philosophy of the service supported by a service user guide. The guide details what the prospective residents can expect and gives a clear account of the specialist services provided, how to make a complaint and all residents are given a copy of the guide. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Admissions are not made to the home until a full needs assessment has been undertaken. For people who are self-funding and without a care management assessment, a skilled and experienced member of staff always undertakes an assessment. The assessment is conducted professionally and sensitively and involves the individual and their family or representative, where appropriate. Where the assessment has been undertaken through care management arrangements the service insists on receiving a summary of the assessment and a copy of the care plan. Prospective residents are given the opportunity to spend time in the home when deemed appropriate and a carefully planned transition. New residents are provided with a statement of terms and conditions or a contract. This sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from having an individual plan of care that reflects their assessed and changing needs. People living in the home are consulted and supported in taking risks as part of an independent lifestyle. People living in the home can be confident that information held about them is handled appropriately and their right to confidentiality is upheld. Evidence: The key principle of the home is that people using the service are in control of their lives and they direct the service. Staff are fully committed in supporting individuals to lead purposeful and fulfilling lives as independently as possible. People using the service make their own informed decisions and have the right to take risks in their daily lives. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Care plans are person centred and are agreed with the individual. Plans are written in plain language, are easy to understand and look at all areas of the individuals life. They include reference to equality and diversity and address any needs identified in a person centred way. Staff have skills and ability to support and encourage residents to be involved in the ongoing development of their plan. Staff make the process interesting and use a variety of ways to help individuals make a worthwhile contribution, for example, through talk time meetings with residents. A key worker system allows staff to work on a one-to-one basis and contribute to the care plan for the individual. Each care plan includes a comprehensive risk assessment, which is reviewed regularly. The management of risk is positive in addressing safety issues while aiming for improved outcomes for people. Where there are limitations, the decisions have been made with the agreement of the person or their representative and are accurately recorded. There are plans to ensure that people using the service have a greater understanding/awareness of their rights and what is available to them, for example, advocacy service, IMCA, Wellman clinic and linked counselling service. All records of a confidential nature are securely stored in the home. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have a range of opportunities that will meet their social, leisure and educational needs and their own personal development. People living in the home are supported in maintaining appropriate relationships with friends and family. People living in the home enjoy a healthy and varied diet that is of their choosing. Evidence: Central to the homes aims and objectives is the promotion of the individuals right to live an ordinary and meaningful life, appropriate to their peer group, in both the home and the community, and to enjoy all the rights and responsibilities of citizenship. The home understands the importance of enabling younger adults to achieve their goals, Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: follow their interests and be integrated into community life and leisure activities in a way that is directed by the person using the service. Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. The home has sought the views of the residents through 1-1 talk times and considered their varied interests when planning the routines of daily living and arranging activities both in the home and the community. Routines are very flexible and residents can make choices in major areas of their life. The service actively encourages and provides imaginative and varied opportunities for people using the service to develop and maintain social, emotional, communication and independent living skills where appropriate. The service has very strong and highly effective methods, which focus on involving residents in all areas of their life, and actively promotes the rights of individuals to make informed choices, providing links to specialist support when needed. This includes developing and maintaining family and personal relationships. There is evidence of innovative methods being used, and staff actively seeking information to enable people to access education and work, including supported employment, and paid employment where they have the capacity. Contact links with local services such as the careers office and job centres are maintained. The service actively supports people to be independent and involved in all areas of daily living in the home. This includes where appropriate, taking responsibility for shopping, planning meals, and meal preparation. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home receive healthcare support in the manner they prefer and require and their physical and emotional needs are met. People living in the home are protected by the homes policies and procedures for dealing with medication. Evidence: Staff are highly aware that the way in which support is given is a key issue for younger adults and residents receive effective healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. Individual plans clearly record peoples personal and healthcare needs and detail how they will be delivered in a separate health action plan. The staff group is balanced to enable choice of male, female and age related preferences when delivering support to residents. The home fully respects the rights of people in the area of health care and medication and they recognise and work with the decisions made by the individual regarding any Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: refusal to take medication, or any specific requests about how their healthcare is managed. Staff members are very alert to changes in mood, behaviour and general wellbeing and fully understand how they should respond and take action. The home has an efficient medication policy, procedure and practice guidance and staff all have access to this written information and understand their role and responsibilities. Quality assurance systems confirm that policy is put into practice. The home strongly promotes independence and those individuals assessed as being able are encouraged and supported to manage their own medication, at present two residents on supervised medication are working towards managing their own medication. Medication records are seen as key to the efficient management of health care matters and the home consistently keeps them up to date. Care staff have the required accredited training with assessments every two years and six monthly checks. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident that their views will be listened to and acted on and they are protected from abuse and neglect. Evidence: People who use the service are supplied with a complaints procedure that they can understand and it is supplied to everyone living at the home and is displayed in a number of areas within the service. Residents spoken with understand how to make a complaint and are clear about what will happen if a complaint is made. The home keeps a full record of complaints and this includes details of the investigation and any actions taken. Unless there are exceptional circumstances the service always responds within the agreed timescale. The home has an open culture where individuals feel safe and supported to share any concerns in relation to their protection and safety. Policies and procedures regarding safeguarding adults are available to staff and give them clear guidance about what action should be taken. There is a clear system for staff to report concerns about colleagues and managers which ensures that concerns are investigated in line with local policies and procedures. The home is clear when an incident needs to be referred to the Local Authority as part of the local safeguarding procedures. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Training records viewed evidence that all staff working within the home are fully trained in safeguarding adults and know how to respond in the event of an alert. Staff members have also received training around the Mental Capacity Act. Individual staff are also trained in Non violent crisis intervention to respond appropriately to physical and verbal aggression and fully understand that physical intervention is a last resort. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely, safe and comfortable environment with sufficient personal and communal space to meet their needs. Evidence: The home provides a physical environment that meets the specific needs of the people who live there. The home is comfortable and has a programme to improve the decoration, fixtures and fittings. The AQAA provided by the home indicates that occasionally there is slippage of timescales and maintenance tends to be reactive rather than proactive. The kitchen door has a broken cat flap and is showing signs of rot and needs repairing or replacing as a matter of urgency. There is also an ongoing issue relating to the availability of hot water in the kitchen area that urgently requires attention to maintain hygenic standards for residents. The home is well lit, clean and tidy and smells fresh. The management has a good infection control policy and staff have received training in infection control. Residents are encouraged to personalise their bedrooms, residents spoken with were happy with their rooms. The environment promotes the privacy, dignity and autonomy of residents and the shared areas provide a choice of communal space with Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: opportunities to meet relatives and friends in private. Toilets are appropriately located within the home, are easily accessible and in sufficient numbers. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported by a competent and qualified staff team in sufficient numbers to meet their needs. People living in the home are protected by the services robust recruitment procedures for new employees. Residents individual and joint needs are met by an appropriately trained and supervised staff team. Evidence: The service has a highly developed recruitment procedure that has the needs of people who use the service at its core. The recruitment of good quality carers is seen as integral to the delivery of an excellent service. The service is highly selective, with the recruitment of the right person for the job being more important to the filling of a vacancy. People who use the service are involved in the recruitment of staff and receive support to do this. Management prioritise training and facilitate staff members to undertake external qualifications beyond basic requirements, currently over 75 of staff in the home have an NVQ qualification. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: All new staff have a 3 month probationary period and are required to undergo an induction programme to SSC specifications followed by the foundation LDQ. The content of the induction and probationary periods are seen to be very robust, detailed and service specific. The service only confirms permanent employment when satisfied that competence and progress has been shown to be satisfactory against their high standards. People living in the home benefit from having well trained and supervised staff to support them. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home that is run by a competent and qualified manager and where their rights and best interests are safeguarded. Residents benefit from living in a home where their views underpin all self-monitoring and development of the home and their health, safety and welfare is promoted and protected. Evidence: The manager has the required qualifications and experience and is competent to run the home and has a clear understanding of the key principles and focus of the service. They work to continuously improve services and provide an increased quality of life for residents with a strong focus on equality and diversity issues and promoting human rights, especially in the areas of dignity, respect and fairness. There is also a focus on developing person centred thinking, with residents shaping service delivery. Observations during the visit demonstrated that there is a strong ethos of being open and transparent in all areas of running of the home. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The manager leads and supports a strong staff team who have been recruited and trained to a high standard. The AQAA returned to the commission contains clear, relevant information that is supported by a wide range of evidence. The AQAA lets us know about changes they have made and where they still need to make improvements. It shows clearly how they are going to do this. The data section of the AQAA is accurately and fully completed. There is also evidence of organisational monitoring through Regulation 26 visits and Quality assurance systems that are in place. Records viewed during this inspection were of a good standard and are routinely completed. Health and safety systems are regularly reviewed and updated and are developed on the basis of experience in the home, outcomes for people using the service and learning from external developments. The manager ensures that all staff are trained in health and safety matters and individual training records reflect this and regular updates are planned ahead. The manager, senior team, and staff at all levels have a good understanding of risk assessment processes which is underpinned by promoting independence, choice and autonomy and these principles are taken into account in all aspects of the running of the home. The home has a comprehensive range of policies and procedures to promote and protect residents and employees health and safety and staff are trained, understand, and consistently follow these. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!