Inspection on 26/03/08 for The Old School House

This inspection was carried out on 26th March 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 Old School House 13/10/06

The Old School House 26/01/06

The Old School House 23/08/05

The Old School House 28/02/05

The Old School House 15/06/04

The Old School House 19/02/04

The Old School House 23/09/03

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

CARE HOME ADULTS 18-65 The Old School House The Old School House Church Lane New Romney Kent TN28 8ES Lead Inspector Lisbeth Scoones Unannounced Inspection 26th March 2008 09:35 The Old School House DS0000023565.V359490.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 Old School House DS0000023565.V359490.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 Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old School House Address The Old School House Church Lane New Romney Kent TN28 8ES 01797 366477 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) osh@c-o-t.org.uk www.canterburyoasttrust.org.uk Canterbury Oast Trust Mr Andrew Alan Nunn Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The 2 residents with physical disabilities should also have learning disabilities Date of last inspection Brief Description of the Service: The Old School House is a purpose built care home for up to eight younger adults with a learning disability. This may include two people who, in addition to a learning disability also have a significant physical disability. The Canterbury Oast Trust is the registered Provider. Mr A Nunn is the registered manager in day-to-day control of the Home. The home is a large, modern, detached property set in a residential area of the town of New Romney. The accommodation comprises eight single bedrooms for resident’s use. There is a large lounge and kitchen dining/room providing communal day space. Residents may access the well-maintained and partially enclosed garden to the rear of the house. Car parking is available to the rear and side of the property. Local facilities (shops, pub, GP, church and post office) are all within walking distance. Weekly fees are £834. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This unannounced inspection was carried out on 26 March 2008 and comprised conversations with some of the residents, discussions with the manager and staff, an accompanied tour of the building and the examination of records and documents. Conversations with the residents provided an opportunity to discuss their experiences and views of the home. Residents said they liked their home and the staff and had plenty to do. interacted with the residents and each other in a friendly, enabling and cheerful manner. Staff Prior to the inspection, a number of residents, with staff help, had completed a comment card. No actual comments were recorded but boxes ticked indicate that residents are happy with the standard of care provided in their home. The inspection was further informed by an AQAA (annual quality audit and assessment) completed by the manager. One recommendation was made and carried over from the previous inspection. It relates to the frequency of staff supervision sessions. What the service does well: The Old School House provides a caring and supportive environment for its residents. There is a range of ever increasing and improving activities available based on the individual and collective needs of the group. These include activities at home, trips out, holidays and attendance at in-house education and social facilities. The home operates in accordance with an effective key working system. Staff work positively with the residents helping them to communicate their needs and develop skills and confidence. Residents’ views and opinions are actively sought. Monthly quality assurance questionnaires are carried out by the key workers. Two-weekly resident meetings are held. The service promotes Equality and Diversity. Evidence of this is incorporated in the report. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 6 There is supportive leadership in the home and good training opportunities for staff. Staff retention in the home is good. Staff like the working environment and very few leave. The home enables residents to maintain appropriate links with families, friends and significant others. 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 summary of this inspection report can be made available in other formats on request. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs and aspirations are assessed prior to and during their stay to ensure mutual benefit and compatibility of the placement. Residents and their families know that goals and aspirations will be supported by the home. Residents are aware, as far as possible, of their roles and responsibilities in the home and know that their independence will be supported. EVIDENCE: There have been no recent admissions to the home and the 8 residents have been living amicably together for some years. The manager said that family members are encouraged to visit the residents in their home. Relatives are encouraged to express views and ideas to meet the residents’ needs. If a new resident were to be admitted, the Trust’s admission process would be initiated. This would include the gathering of information from all relevant The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 9 parties before a decision is made about the permanency of the placement. Every effort would be made to ensure that the move to The Old School House would be appropriate, mutually beneficial and support needs could be met. The current inspection report was seen on display as well as the Statement of Purpose and Service User Guide (both in a colourful and pictorial format). The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents’ care plans and other care documentation are clear, accessible and identify the needs of the residents. Staff have a good understanding of resident’s rights and residents are enabled to make decisions affecting their daily lives. Residents are supported to take risks within a risk-assessed framework. EVIDENCE: Residents’ care records contain comprehensive detail on physical and social needs, health care, medical information, behavioural guidelines and reviews. Residents and their representatives are encouraged to be involved in the devisising of their care plan and participate in regular reviews. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 11 Residents are encouraged to express their views and are consulted whenever appropriate and possible. See also standard 22 in respect of “Talk time”. Monthly one to one talks provide another opportunity. There is a structure to the weekdays but routines remain flexible. Decisions are made and choices determined on a daily basis. The care plans include ‘goals’ in respect of choice and aspirations. The manager said that residents are encouraged to sets new goals relating to independence. As evidenced in risk assessments seen, the potential hazard of any activity, including holidays, is looked into in a positive manner. As a result residents can participate in chosen activities with appropriate support. Residents are provided with training in respect of their own safety and risk taking. Examples of such training relate to health and safety, food hygiene and first aid. Certificates for any training participated in are kept in residents’ files. It was observed that staff interacted with the residents in a friendly, interactive and inclusive manner. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents are provided with many opportunities for personal development. Residents’ days are occupied with things they like to do. Residents are provided with an opportunity to experience holidays away from the home. The home promotes good relationships with residents, their relatives and staff. Daily routines promote individual skills and responsibilities. Residents are involved in the choice and preparation of a varied and balanced menu. EVIDENCE: The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 13 In conversation with residents and staff, they confirmed that the educational and leisure activities on offer at the home are much enjoyed. A resident spoke proudly of his work on the farm and the artwork he had created. A written programme of activity is displayed in the office. Residents are supported to attend regular day services. The programme includes individual, group, in house and community based activity. There is a balance of social, educational and physical activity. Some of the programmes include independent living skills training such as accessing the community independently. Residents are enabled to practise their religion as evidenced in care records seen. Daily records confirm involvement or give reason for non-implementation of the programmes. There is a minibus (and several residents have their own car) for transporting residents to and from trips out and social venues. The purchase of a ‘people carrier’ is being considered. Residents are encouraged to keep the home and their rooms clean, tidy and hygienic. Those residents present at the time of the inspection were spoken with. One resident enjoys a considerable amount of involvement in determining how and where time is to be spent, whilst another resident confirmed his enjoyment of the day care activities and was looking forward to a holiday to Centre Parcs and ‘Longleat’ in June. Previous holidays include a trip to Disney Land and adventure activities such as caving, abseiling and kayaking. The home supports the residents’ wishes to form relationships. have recently become engaged. Two residents Residents are provided with a wholesome, healthy and varied diet. They are encouraged to be involved with the shopping, preparation and tidying up. Residents are involved in choosing what they would like to eat. On the day of the inspection, staff and residents were sitting around the kitchen table planning next week’s menu. This was done with the help of pictures of food items. Menus were seen on display. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are treated with respect and their right to privacy respected. Residents’ healthcare needs are kept under review and addressed. Residents are protected by the home’s medication policies and procedures. The health care needs of the residents are monitored and addressed. EVIDENCE: Staff are committed to treat the residents with respect for their privacy. The manager said that a visual alert has been installed in a resident’s room after seeking advice from Kent ‘deaf services’. Instead of knocking on the door, the visual aid would alert the resident that someone wishes to come in. The resident can act according to his wish. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 15 Cordless phones have been purchased to give resident the freedom to make and receive phone calls in private. These are good examples of the home’s commitment to promote independence and choice. Records in care plans evidence that residents’ health care needs are met. Residents have access to a GP and medical specialists, Epilepsy nurse, continence advisor, dentist, chiropodist, optician and members of the learning disability team and occupational health therapist. Staff keep on eye on residents’ weight and nutritional needs are assessed. Medication storage and administration record evidence that good systems are in place for the safe administration of medication. Comprehensive records are maintained including those for signing out medication when a resident is absent for a while. It was recommended that the return of medication following absence would also be recorded. Staff are well trained and competency assessed. Such training would include Epilepsy and the administration of rectal medication. In respect of Epilepsy, seizures are entered onto a spreadsheet to aid review of incidence and management of the condition. Medication reviews are carried out. Self–administration is encouraged. One resident is now independent in all aspects of the medication including collecting the prescription, recording and safe storage. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ views and concerns are listened to and acted upon. Systems are in place to promote and maintain protection from abuse. EVIDENCE: There is a ‘Trust’ complaints procedure in place, which is also available in pictorial format. The manager said that he operates an ‘open door’ policy. “Talk time” has been introduced to assist and encourage residents to interact with staff in raising concerns and express choices. The complaint file evidenced that complaints are taken seriously, resolved and recorded. The manager confirmed that policies relating to safeguarding vulnerable adults, whistle blowing, restraint and guidelines are available to staff. Staff spoken with demonstrated a good knowledge of such issues and said that they had attended training. Incidents that may be construed as abuse are appropriately referred to the lead authority. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are well maintained, spacious, homely, clean and hygienic. The home provides a comfortable environment in which to live and work. EVIDENCE: At the time of inspection visit the home was homely, clean and tidy. Pictures painted by the residents were seen on display in the lounge. It is evident that the home is well maintained and constantly improved. As stated in the AQAA, “ 25 of the house is decorated every year by contractors supplied by Downlands Housing Association.” Various improvements have been made and furniture and equipment purchased for the benefit of the residents. An example is a 42” television in the communal lounge, which will support residents with visual impairment. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 18 At the invitation of two residents, their bedrooms were viewed which were comfortably furnished and personalised according to their taste and choices. Residents are free to come and go within and outside the house subject to risk assessments and security. Residents are encouraged to take part in keeping he home clean and tidy. A part-time domestic support worker is employed. Whilst overall clean, a rusty radiator was noted and some grouting in bathrooms that needed additional attention. There are a number of bathrooms and showers. With the input of the occupational therapist, one bathroom has been specially adapted for the use of a resident thus promoting independence. The residents can sit outside in the garden. It is the manager’s intention to provide additional garden furniture. Staff carry out monthly health and safety checks. Any maintenance repairs are dealt with without delay. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s recruitment practices. Staff are supported to access training courses to enable them to work more effectively with the residents. Staff are currently not provided with formal supervision in line with the NMS recommended frequency. EVIDENCE: Staff comprises the manager, team leader and support workers. The home is fully staffed and when necessary, flexi staff provide cover for sickness and holidays. Staff retention is good with some staff having worked for the company for many years. This includes the manager. It is evident that staff enjoy their work and like the residents and each other. There was an atmosphere of support and team working. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 20 Sufficient members of staff are on duty at the home during the day and to support various activities. A training matrix is in place. Staff are encouraged and supported to attend statutory and service specific training courses as well as NVQ care at appropriate levels. The home has achieved a ratio of at least 50 staff who are NVQ trained. Level 3 is encouraged. Staff are provided with Skills for Care induction training through a local college. Other recent training includes dementia care. A sample of staff files was examined. This demonstrated robust recruitment procedures including POVA and CRB checks. Following training, staff have had a formal appraisals. Staff are supervised but not as regularly as the NMS recommendations. Now the manager is back in home full time, it is his intention to action this. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home is well run with an ethos of inclusion, support and development. The health, safety and welfare of those who live and work in the home is promoted and protected. EVIDENCE: The manager Andy Nunn has been the registered manager for a number of years. He has an NVQ 4 in Care and the RMA (Registered Managers Award). Staff spoken with said that he is an approachable, positive and supportive manager. A resident said, “He is nice”. He operates an open door policy and frequently meets with staff individually and collectively. The atmosphere is open and inclusive. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 22 Mr Nunn has recently spent some time away from the home to support another service. This has now come to an end. The manager is supported by a team leader and the company’s senior staff. On call systems are in place to ensure a management presence at all times. Good training opportunities are provided such as NVQ assessors training for team leaders. Good systems are in place to encourage residents to voice their opinions at any time relating to any issues of importance to them. As already referred to, there are one tot one and “talk time” sessions, care reviews and monthly residents’ meetings to facilitate this. Twice yearly, satisfaction surveys are completed with the assistance of key workers and questionnaires sent to parents and care managers. Quality assurance questionnaires and two-weekly residents meeting are carried out. The home is regularly visited by a representative of the organisation not directly involved with its management and reports submitted in accordance with Regulation 26. Systems are in place that ensure the home is safe and well maintained. The information in the AQAA evidences the checks carried out when due. Accident and incident records are well maintained and the CSCI and other authorities notified when appropriate. The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 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 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 4 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 3 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 x x x x 3 4 The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 24 N/A 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. Standard Regulation Requirement 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 YA36 Good Practice Recommendations That the frequency of staff supervision meet the NMS The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Old School House DS0000023565.V359490.R01.S.doc Version 5.2 Page 26 - 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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