Inspection on 19/09/06 for The Laurels

This inspection was carried out on 19th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Laurels 16/09/08

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 09/07/2008.

CARE HOME ADULTS 18-65 The Laurels 209 Faversham Road Kennington Ashford Kent TN24 9AF Lead Inspector Mrs Sue Gaskell Unannounced Inspection 19th September 2006 10:00 The Laurels DS0000065341.V303639.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 Laurels DS0000065341.V303639.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 Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Laurels Address 209 Faversham Road Kennington Ashford Kent TN24 9AF 01233 635932 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) CareTech Community Services (No.2) Ltd Mr Mark Reay Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users with learning disabilities is restricted to two (2) whose DOB are 16/10/1980 And 09/10/1961. 25th October 2005 Date of last inspection Brief Description of the Service: The Laurels cares for 5 people with mental health problems and 1 person with a learning disability. The fees range from £1030 - £1533 per week. 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, colleges, a cinema, library and bowling alley. The home has access to all necessary healthcare services within the community. The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 19th September 2006 between 10.00am and 4.00pm. There are 5 people currently living in the home. The inspector spoke to the 5 residents, 2 of who showed her their bedrooms, and also spoke to the manager and 2 members of staff. The inspector also spent time chatting with residents in order to see whether they appeared relaxed and comfortable. The inspection process consisted of information collected before and during the visit to the home, and care management feedback after the site visit finished. Other information seen included incident report forms, assessment and care plans, medication records, duty rota and staff employment and induction paperwork. 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. The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 6 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 Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. . This judgement has been made using available evidence including a visit to this service. The statement of purpose, service user guide and individual statement of terms and conditions, clearly says what service will be offered. Prospective residents can be confident that their needs will be assessed and can be met. EVIDENCE: There has been one admission to the home since the last inspection visit. That person’s file contained a detailed and comprehensive pre-admission assessment. The resident made several visits to the home prior to moving in. The home does not take emergency admissions. All residents have been issued with a service user guide and part of this is in a pictorial format. Residents also are issued with individual agreements stating their terms and conditions of residence. The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service user plans are easy to use and descriptive. Residents’ choices are respected and their decision-making is well supported. Residents are supported in taking risks in the daily and social activities that form part of an independent lifestyle. EVIDENCE: The residents said that they are asked about how they want to be supported and they are encouraged to have as much input as possible to any decision affecting their lives. The care plans and reviews are signed and agreed by residents and clearly record the individual resident’s views. All of the care plans include details on short and long term goals and how the home will assist residents in achieving their goals. The home has found that general resident’s meetings are not practical at present but this may change if the client group changes. However staff confirmed that residents can make their views known about their needs and wishes, eg regarding their care, meals, holidays or The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 9 activities, through the weekly “talk time” sessions. Comprehensive risk assessments have been prepared and include specific guidelines. Care plans and assessments have been reviewed. On the day of the inspection there was the registered manager, Team leader and 2 support staff on duty. Staff confirmed that issues relating to confidentiality are addressed during the induction period. All records are stored in a lockable office and there was no public display of confidential or personal information. The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Daily life generally meets the residents’ lifestyle preferences and expectations. Residents’ ability to engage in appropriate leisure activities could be compromised occasionally by lack of staff. Residents have regular contact with their families and friends and receive a nourishing and balanced diet. EVIDENCE: The residents are supported by the staff and manager to participate in a range of activities and events for leisure and therapeutic purposes. There is a weekly programme of activities but this is flexible according to residents changing needs and wishes. The home assists residents in seeking appropriate employment and one resident said that he really enjoys his current job and the fact that he is helping others. The care plans contain a list of residents’ needs, likes and dislikes and preferences. Residents may come and go as they please, The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 11 subject to any needs identified in the care plan, and one resident said that he often stays up till very late. Families, advocates and other visitors are encouraged and welcomed and restrictions would only be placed in accordance with the wishes of the residents or following a risk assessment. Meals are provided mainly based on residents’ choices identified during the “talk time” sessions, but also taking into account the need for a reasonably balanced diet. One resident has particular needs which require special consideration. Residents said that they are involved in devising the menu plan and accompanying staff in shopping for provisions. Some residents also have the opportunity to prepare food under supervision, or assist staff to prepare meals that they have chosen. The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 & 21 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ choices over their care are respected. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. Residents and staff are supported at times of illness and bereavement. EVIDENCE: All of the residents were on the premises at some time during the inspection and were seen to be relaxed and comfortable interacting with staff. Residents care plans and daily records referred to clear guidelines on providing support and monitoring health care and social care needs. There was evidence to show that residents had been referred for specialist help whenever necessary. The manager and all members of staff showed a high level of awareness of residents’ needs and referred to issues, such as the negative effects of certain foods on one resident, being included in the care plans. The home has sound medication procedures. Staff confirmed that only trained staff would administer The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 13 medication and that all staff have to read the procedures stored in the medication file. Medication was stored securely and appropriately and the medication records were clear and current. Issues around illness and end of life are managed with great care and sensitivity, and residents and staff have been provided with appropriate support for as long as they require. The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. 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. Residents can be confident complaints will be listened to and dealt with appropriately and they will be protected from abuse. EVIDENCE: Two residents said that they would feel comfortable telling staff about anything they are not happy with. The manager and staff said that every effort is made to ensure that residents can communicate their feelings if they are not happy with something and that staff discuss this with residents during their individual weekly “talk time”. The home uses complaints forms and there were copies of these in each residents’ file. The home has adult abuse procedures in place and staff confirmed that they have received training on adult protection. Staff were aware of the company’s “whistle blowing procedures” and the manager said that this procedure is reviewed regularly. The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a homely,comfortable and safe environment. The home is hygienic and clean EVIDENCE: The living areas are generally furnished and decorated to a reasonable standard, and contained the type of furniture and equipment necessary to provide a homely environment. The smoking room has been equipped with new furniture this year but there is an on-going problem with one particular resident whose behaviours include mis-use of cigarettes. The furniture meets fire safety regulations and appropriate risk assessments have been prepared. All areas were seen to be clean and hygienic but there are several areas requiring maintenance or attention, eg some plasterwork in the area outside the ground floor bathroom, general wear and tear in the hall and landing areas and 1 bedroom. Residents said that they are happy with their bedrooms and that they had chosen some of the colours, furniture etc. but some of the bedrooms require attention or would benefit from general upgrading. There are no specialist baths or other adaptations at present but this would be reviewed The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 16 if one particular residents needs change. A new shower has been fitted since the previous inspection. Windows are fitted with restrictors. There is a secure garden which has been improved since the previous inspection by having an old brick and glass conservatory removed. The registered manager and area manager acknowledge that improvements need to be made but are planning timescales around any changes to the current client group. The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 & 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a team with a wide range of skills. Staffing numbers are appropriate to meet the service users’ needs and wishes. Recruitment practices are sound. Training provision and staff support is good. EVIDENCE: The manager and staff said that the current staff rota is adequate to meet residents’ care needs and ensure that residents can participate in any chosen activities. Night staffing of one waking and one sleeping staff also appears adequate. Staff confirmed that there are on call systems in the event of an emergency. There are sound recruitment practices and all staff have to be CRB checked and have verbal and written references prior to their employment. One of the newer members of staff confirmed that she had received a comprehensive induction training with core issues covered initially and then further on-going training. Recent training has included adult protection awareness, medication, infection control and issues around mental health. Staff said that they are encouraged to identify any particular training needs The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 18 and further training is planned for medication and health and safety. Staff confirmed that they receive regular supervision from the manager and there was evidence of this in staff files. The staff group has remained stable in the past twelve months and the manager said that residents have benefited from this, eg in providing a stable and consistent environment. Staff referred to the high level of team work, and on-going support from the Manager for work and personal issues affecting their work. The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported and protected by the effective management of the home. The company encourages input from residents and regularly reviews its procedures, thus benefiting the residents lifestyle and safety. Health and safety in the home is promoted. EVIDENCE: Staff said that the home is run for the residents and that residents’ views and feelings are regularly questioned and monitored, generally through the weekly individual “talk time” sessions. The residents consent to the talk time sessions being recorded. The general management of the home and completion of records are generally of a good standard. The records are regularly checked by the registered manager, with further checks by the area manager during the The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 20 monthly regulation 26 visits. The home is also subject to an annual announced and unannounced quality audit, carried out by an independent organisation. Quality assurance in terms of the residents is also given a high priority and any feedback from residents and/or their families or advocates is acted upon. Staff said that the manager is supportive and the manager was very ready to praise his staff team. There were no obvious hazards around the home and there was evidence to show that health and safety issues are taken seriously eg staff ensuring that hazardous chemicals are locked away. The maintenance file contains current certificates to show that regular checks eg gas, electricity, are carried out and there are records of checks on the environment and risk assessments. The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 21 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 X 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 X 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 4 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 4 4 X 4 X X 4 X The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 22 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 YA28 Regulation 23 Requirement Provide programme of maintenance and redecoration with commitment to commence programme in next 6 months. Timescale for action 20/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Laurels DS0000065341.V303639.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 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. 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