Inspection on 27/07/05 for The Paddock

This inspection was carried out on 27th 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.

Other inspections for this house

The Paddock 08/01/09

The Paddock 23/01/08

The Paddock 30/08/07

The Paddock 01/09/06

The Paddock 05/10/04

The Paddock 14/04/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Paddock 80 High Street Lydd Kent TN29 9AN Lead Inspector Wendy Mills Announced 27 July 2005 9:30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Paddock Address 80 High Street, Lydd, Kent, TN29 9AN 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) 01797 321292 Laurence John Waitt and Shaun Rigby Waitt Judy Rees Care home only 19 Category(ies) of Learning Disability x 19 registration, with number of places The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: there is a variation for one person with a learning disability who is over age of sixty-five Date of last inspection 5th October 2004 Brief Description of the Service: The Paddock provides residential care for 19 service users with learning disability. It is a large detached house set in pleasant gardens. It is situated in the small coastal town of Lydd and the local shops, church and public houses are all within walking distance. The larger towns of Ashford, Folkestone and Hythe are all within easy driving distance and the home provides adequate transport in order to access the available educational, recreational and cultural facilities. In addition the gardens surrounding the home there is an allotment where the service users are supported to grow some of the fresh produce for the home. Service users access both general and specialist medical and dental services through the local primary health care team. The home supports and encourages the maintenance of family links and friendships The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection began at 09.00hours and lasted seven and a half hours. The inspector was assisted throughout by the registered manager, Mrs Judy Rees and for a part of the inspection by the group administrator, Ms Sally Dickenson. Both are thanked for their assistance with this inspection. During the course of the inspection the inspector spoke to ten residents and four members of staff. Detailed discussions were held in private with three residents and three members of staff. A pre-inspection questionnaire was sent out to the residents and their relatives. The responses were positive and demonstrated a high level of satisfaction amongst the respondents. A tour of the home was undertaken, key documentation inspected and sample care plans examined in detail. Both direct and indirect observations were made throughout the inspection. The Home continues to maintain a good quality of care that meets the National Minimum Standards. Most of the residents said, or indicated, that are happy in the home although one resident does not feel that the home meets his needs. Residents are able to participate in the running of the home if they wish to and are able to do so. Staffing levels are good and staff told the inspector that they really enjoy their work with the residents. Staff training is linked to the needs of the residents and there is a good level of training and development taking place. The Home has good quality monitoring systems and the manager has a clear vision for the improvements needed in the home. Since the last inspection there has been considerable improvement to the environment. Both the lounge and dining rooms have been redecorated, new flooring laid and new dining room furniture provided. There is an ongoing programme to redecorate the residents’ rooms. What the service does well: The Home provides a comfortable and homely environment in which there is a high level of mutual respect. Many residents have complex needs and the home accesses specialist help in order to improve independence levels. Staffing levels are good and there is a cohesive staff team who work together to the benefit of the residents. Staff training is good and now over eighty percent of staff hold an National Vocational qualification at level II or above. The registered manager, Mrs Judy Rees, holds the NVQ level IV in management and care and has recently embarked on a foundation degree in The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 6 health and social care at the Broadstairs campus of the University of Canterbury. The Home accesses a wide range of activities on behalf of the residents. These activities are tailored to meet individual needs. In addition, it offers good support to relatives and friends who visit the Home. The internal long-term planning and quality assurance systems are good and the group administrator visits regularly and maintains an excellent working relationship with the registered manager. 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 Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1&5 The statement of purpose and the service user guide are good. The residents are aware of their roles and responsibilities and know that their independence will be promoted. They know that their goals and aspirations will be supported by the Home. EVIDENCE: The statement of purpose and the service user guide enable residents to understand what to expect from the Home. No new residents have joined the Home since the last inspection. Residents said that the Home helps them do the things they want to and helps them live interesting and enjoyable lives. Indirect observation confirmed that staff encourage the residents to be as independent as possible. Individual needs and goals are reflected in the care plans and risk assessments are in place The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9&10 The residents and their supporters know that the Home will respect their confidentiality and value their views. There is a clear and consistent care planning process that the residents and their supporters understand and records are maintained securely EVIDENCE: Both direct and indirect observation showed that staff support the residents to participate in as far as is possible in decision making. There is a key worker system and staff advocate clearly for those residents who are unable to express themselves easily. There are regular house meetings and staff told the inspector that they can discuss ideas for improving the Home and any other general concerns at these meetings. They also said that they can talk, on a day-to-day basis, to the registered manager or team leaders about any concerns they may have about the residents. The residents to whom the inspector spoke in more detail said that they are consulted about issues in the home. they said that they did not always like some of the restrictions placed upon them but understood that restrictions, for example, on the amount of cigarettes, are made for their own good. The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 10 On the day of inspection some of the residents were participating in household tasks. Although some need more encouragement and assistance to carry out their duties, they were observed to be given appropriate support by the staff. Responses to the CSCI questionnaire that is aimed at relatives and supporters were all positive. Relatives said that they were happy with the care at the Home and that the Home fosters good communication. Inspection of care plans confirmed that they are in order, up-to-date, and clearly identify the needs of the residents. Staff are clear about their responsibility in respect of confidentiality and record storage. The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16&17 The home offers good opportunities for the residents to participate in a wide range of appropriate activities. It assists and encourages the residents to lead fulfilling lives. The quality of meals is very good and special diets are catered for when indicated. EVIDENCE: Staff said that the residents take part in lots of leisure and educational activities. On the day of inspection some of the residents were going horse riding. One resident showed the inspector all the craft work he has done. He has a large collection of tapestry pictures and pottery that he has made. Residents participate in the local community, they shop locally, sometimes go to church and one resident uses the local library. One resident now has her own mobility car and now enjoys going out with her friends. The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 12 Since the last inspection the dining room has been tastefully re-decorated. There are new dining tables and chairs and new flooring. This makes the room appear much more lighter. Conversation with the cook confirmed that there is a plentiful supply of good quality produce. The Home offers a choice of meals to the residents. Residents said that they mostly enjoy their meals. The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19&20 Personal support is offered in a way that protects the privacy and dignity of the residents and promotes their independence. There are clear and comprehensive systems for the management and administration of medicines. EVIDENCE: The residents said that the staff respect their confidentiality and that they are happy to discuss personal issues with the staff. Indirect observation confirmed that personal care, when needed, was offered in a discreet and sensitive manner. Inspection of the systems for ordering, recording and administration of medication, and discussion with the registered manager, confirmed that improvemtn has been made in the way medicines are checked as they come into the home. Improvemtn have also been made in the way the home liaises with local health care professionals to ensure that levels of medication are no higher than necessary The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 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 standard(s) 22&23 Staff have a very good knowledge and understanding of Adult Protection issues and how to protect the residents from all forms of abuse. The residents know that their concerns will be listened to and acted upon. EVIDENCE: Indirect observation showed that the residents were comfortable talking to any of the staff or the registered manager. Some residents said they could talk to the manager about any concerns they may have. Inspection of staff training records, discussion with the registered manager and other staff showed a high level of commitment to staff training. In particular, there is excellent in-house training in Adult Protection issues. Staff who spoke to the inspector demonstrated a very good understanding of adult protection. All said that they would immediately report any concerns if they suspected abuse. The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 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 standard(s) 24,25,26,27,28&30 The standard of the environment within the Home is good and provides the residents with an attractive and homely place to live. EVIDENCE: A tour of the Home was undertaken. The communual areas are tasteful and have been recently decorated. New flooring and furnishings have also been obtained for these areas. The residents said they are pleased with their rooms and their rooms are personalised and reflect the individual interests and tastes. A redecoration and refurbishment programme for the bedrooms is currently in progress. The residents are able to choose their own colour schemes with the support of the staff. All areas of the Home were very clean and hygienic on the day of inspection. The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35&36 The staff have a good understanding of the residents needs. Staff have forged positive relationships with the residents. Staff are enthusiastic and morale is high. Staffing levels are good and considerable progress has been made in staff training. Recruitment practices are sound and appropriate vetting procedures are followed. EVIDENCE: Staff spoke very enthusiastically about their roles in the home. Indirect observation showed that there are good relationships between staff and the residents. There are clearly defined staff teams and staff said that they are clear about their roles and responsibilities. Since the last inspection more progress has been made in staff training. The registered manager has attended a “Train the Trainer” course and has now established an in-house training programme. This programme includes Adult protection training and moving and handling. There has been recent specialist training in autism that the staff found very interesting and useful. Now over eighty percent of staff hold the NVQ at level two or above. The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,42&43 The manager is well supported by the senior staff in providing clear leadership throughout the home. She has a good understanding of the areas where improvement is needed. EVIDENCE: The registered manager holds the NVQ IV in management and care and the registered manager award. In addition she is qualified to carry out NVQ assessments in-house. She is currently undertaking a foundation degree in health and social science. She has signed a three-year loyalty contract with the company. The company are funding her continuing professional development. Staff said that she is very supportive and approachable. They said that they felt well supported by the management team and believed they could develop their careers in care within the home. Both staff and the manager have a good understanding of the likes and dislikes of the residents. The staff help the residents to contribute to decision making in the home and advocate for them. The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.doc Version 1.40 Page 18 The registered providers ensure that regular quality assurance visits are made. During the inspection the interaction of the residents with the company’s representative was observed. It was clear that they were used to her visits and had a friendly and easy relationship with her. They have invested in making improvements to the environment of the home and in staff training. Documentation at the home is of a good standard and policies and procedures are up-to-date and in good order. No health and safety hazards were noted on the day of inspection. The Paddock H56-H05 S23264 The Paddock V230909 270705 Stage 4.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 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 4 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Paddock Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 3 3 H56-H05 S23264 The Paddock V230909 270705 Stage 4.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 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 19 Good Practice Recommendations The home should review the way it records and monitors weight. It should ensure that any action taken if a significant weight change is noted is clearly recorded in care plans. 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