Inspection on 17/11/06 for The Penant

This inspection was carried out on 17th November 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Penant 24/05/07

The Penant 21/03/06

The Penant 23/12/05

The Penant 05/11/04

The Penant 09/07/04

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

CARE HOME ADULTS 18-65 The Penant 7-9 Harold Road Clacton on Sea Essex CO15 6AJ Lead Inspector Neal Cranmer Key Unannounced Inspection 17th November 2006 09:30 The Penant DS0000054579.V302298.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 Penant DS0000054579.V302298.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 Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Penant Address 7-9 Harold Road Clacton on Sea Essex CO15 6AJ 01255 475688 01255 475306 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) The Regard Partnership Limited Mrs Elizabeth Anne Barfield Care Home 10 Category(ies) of Learning disability (10), Learning disability over registration, with number 65 years of age (3) of places The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 10 persons) Three named persons over the age of 65 years who require care by reason of a learning disability The total number of service users accommodated in the home must not exceed 10 persons 21st March 2006 Date of last inspection Brief Description of the Service: The Penant comprises of two Victorian dwellings joined by a connecting door, located close to the sea front at Clacton on Sea and the amenities the area has to offer. The home is managed by one registered manager and accommodates six people with a learning disability. The accommodation offers single rooms all of which, bar one, have en-suite facilities. There are adequate communal and bathing facilities. The front garden is mainly laid as a hard standing for vehicle parking, with a small-bordered area. The rear garden is enclosed and is also mainly laid as a patio area with some small-bordered areas. The fee range for staying in the home are between £460.00 to £1,500.00 per week, with additional charges being made for: Hairdressing, toiletries, magazines and personal items. This information was provided in the Pre Inspection Questionnaire that was summated to the CSCI on the 23rd October 2006. The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced key inspection to the home, which took place over one day in November 2006, lasting 5.00 hours. The inspection process included discussion with two service users, the registered manager and one member of the care team. Tour of the premises included observation of service users bedrooms, bathing and toilet facilities, as well as communal areas and gardens. During the course of the inspection a range of documentary evidence was sampled. Twenty-two of the forty-three standards were inspected, of these eighteen were met, three were partially met, with the remaining one constituting a major shortfall. What the service does well: What has improved since the last inspection? The Statement of Purpose and Service Users Guide has now been reviewed and is provided in a format that is appropriate to the needs of the service users. The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 6 The issue of service users personal monies being paid into any other account than one in the name of the service user has now been satisfactorily resolved. There is now evidence that all new staff employed in the home are being appropriately inducted. The registered manager has now successfully completed their N.V.Q level 4 in management. Service users healthcare records are now being maintained clearly and concisely and in a format that makes them more readily accessible. 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 Penant DS0000054579.V302298.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 Penant DS0000054579.V302298.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): 1 and 2. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service. Prospective service users can expect to be provided with the necessary information to enable them to make an informed choice about the home’s suitability to meet their needs. Service users can expect that their needs will be appropriately assessed prior to any admission to the home. EVIDENCE: The home’s statement of purpose has been reviewed since the previous inspection to the home, and is now also available in a format that is more appropriate to the needs of the service users residing at the home. There have been no new admissions to the home since the previous inspection, so it was not possible to view any current admission paperwork, however the home does have in place a comprehensive pre-admission needs assessment Performa, which covered the following areas: General healthcare, Diagnosis, Prescribed medication, Personal care needs, Communication needs, Mobility, Personal relationships, And how service users liked to spend their leisure time. The Penant DS0000054579.V302298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service. Service users can be assured that their needs and changing needs will be reflected in their individual plans of care. Service users can expect to be supported to make decisions about their every day lives. Service users can expect to be supported to take risks as part of maintaining an independent lifestyle. EVIDENCE: Service users care plans are generated from the home’s pre-admission needs assessment, which covers all areas of service users personal, social and healthcare needs, each service user has a designated key worker who is involved in the care planning process. The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 10 None of the service users residing at the home are able to manage their own financial affairs, although all have their own bank accounts which staff support service users to access. At the previous inspection to the home concern was expressed about the arrangements in place for staff to support service users with their personal monies, since then a policy/ procedure has been developed, which minimises any potential financial risks to both service users and staff. Risk assessments were in place for the following activities: • There was evidence of risk assessments having been undertaken, which identified the nature of the risk, people who maybe affected, and any control measures that were in place. Risk assessments were in place for the following activities: • • • • • Accessing the community Personal Care (female service users) Manual handling Epilepsy Risks of scalds and burns. The home has in place a procedure to be followed for responding to unexplained absences. The Penant DS0000054579.V302298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported to partake in activities that are peer and age appropriate, both within the home and in the community. Service users are supported to maintain links with their families and friends. Service users can expect that their rights and responsibilities will be recognised in their daily lives. Service users can expect to be provided with a diet that is healthy and nutritious. EVIDENCE: The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 12 The needs of the service users are such that none of them are able to partake in any form of paid or voluntary employment, although sampling of records and activity plans showed that one service user attended the local adult education college. The home provides access to transport, and is situated close to public transport facilities, discussion with one service user indicated that they do attend activities in the community e.g. going shopping, going for meals out. The home’s policy on the receiving of visitors is open door, with visitors being free to visit at any reasonable time of day, key workers support service users to maintain links with their families and friends through use of the telephone, sending cards and photographs of holidays, Birthday and Xmas cards, one service user maintains contact through e mail. Service users are free to choose where they receive their visitors. Observation of interactions between staff and service users indicated that the daily routines of the home are designed to promote and maximise independence; service users were witnessed having unrestricted access to all areas of the home. Interactions heard between service users and staff were heard to be appropriate with staff talking to service users in respectful and considerate tones. One service user spoken with during the course of the inspection was very complementary about the home, and the way in which staff supported them, stating that they were always polite, and when asked confirmed that staff always knocked on their bedroom door before entering. All service users rooms were able to be locked from the inside, should the service user wish to do so, although an override devise was fitted which could and would be used by staff in the event of an emergency. The home operates a four-weekly rotational menu, which showed that three meals are provided daily, at least one of which was hot, the menu seen was varied and nutritious, and service users spoken with stated that the meals provided were very nice. Records were seen of the home recording meals consumed by service users. The Penant DS0000054579.V302298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service. Service users can expect to receive personal support in a way that they prefer and which is appropriate to their needs. Service users can expect that their physical and emotional health care needs will be well met. Service users can expect to be protected by the home’s policies and procedures relating to medicines. EVIDENCE: Discussion with service users indicated that staff were sensitive and flexible when supporting them with their personal needs, always ensuring that their privacy and dignity was maintained, by ensuring that personal support was always carried out in the privacy of their own room, the service user stated that they have a clear choice about when they wish to retire to bed and get up in the morning. Observation of service users rooms showed that they had the The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 14 necessary aids available to them to enable them to maximise their independence, some of these included: Hand grab rails, specialist bath aids and toilet seats. All service users are registered with a General practitioner, and health records sampled indicated involvement/access to the following healthcare professionals: General Practitioners, Chiropodists, Community nurses, Dentists, Social workers and Opticians, healthcare records were clearly and concisely maintained. Service users medication is dispensed via a Measured Dosage System or directly from individually named containers, the home does not maintain any controlled medicines. All of the home’s care staff with the exception of two have received training in the safe handling of medicines, and for these two members of staff the home is awaiting the next available date for the training, in the meantime the registered manager confirmed that they do not administer medication to service users. To supplement this training the home carries out its own annual medication up date programme. On the day of the inspection the home’s medication records were sampled and found to be in order, medication is returned to pharmacy via a returns book. The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 15 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 and 23. Quality in this outcome area is (Adequate). This judgement has been made using available evidence including a visit to this service. Service users can expect that their views and concerns will be listened to and acted upon. Service users can expect that the home’s practice will protect them from the risk of harm and or abuse. EVIDENCE: There have been no complaints made about the home since the previous inspection, either directly to the home or the CSCI, the complaints policy is corporately developed and meets with regulatory requirements, the home maintains a log for the recording of any complaints received. Discussion with service users indicated that they were aware of whom to speak to in the event that they were unhappy about any aspect of the care provided in the home. Since the previous inspection to the home there has been one Adult protection referral made, which was accordingly investigated, the outcome of which should have lead the home to considering its responsibilities for referring to the Adult protection list, discussion with the registered manager indicated that this action had not been undertaken by the organisation, this therefore gives some reason for some concern as to whether the organisation is fully discharging its responsibilities in keeping vulnerable people safe. The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 16 All staff have received training in Adult protection with the exception of one, although the registered manager is in the process of pursuing this. The Penant DS0000054579.V302298.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, and 30. Quality in this outcome area is (Adequate). This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported in an environment that is homely, comfortable and generally safe. Although the home was clean and hygienic, laundry arrangements for the home are barely adequate. EVIDENCE: Service users are supported in an environment that is homely, comfortable, and for the most part safe, the environment was bright and airy and was free from any unpleasant odours. Furnishings and fittings were all of a very good quality and were domestic in nature, and the home was decorated to a high standard internally, although this was not replicated to the outside of the premises, where it was noted that there were areas of the outside that posed The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 18 potential risks to both service users and staff e.g. the patio area was uneven and in places slabs were loose and moving. The premises are in keeping with the local community, and is situated close to a wide range of local amenities, and support services e.g. drop in centres for people with a learning disability. The home’s laundry facility is adequate, but barely so, being situated in outdated outbuildings at the rear of the property, the facilities provided do not replicate the high standard that can be found internally, and in the view of the inspector let the home down. The Penant DS0000054579.V302298.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 and 35. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service Service users can expect to be supported by a team of staff who are competent and appropriately qualified. Service users can expect to be supported and protected by the home’s recruitment policies and practice. Service users can expect that their individual and joint needs will be met by staff that are appropriately trained. EVIDENCE: The home employs nine care staff, of which two are qualified at N.V.Q level three, a further two hold the level two award, and in addition a further two are in the process of undertaking the level two award. The home does not employ any carers under the age of eighteen, and those being left in a position of being in charge of the home are all aged over twenty-one. The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 20 Four staff files were sampled in relation to the home’s recruitment practice, one of those sampled indicated an issue on the persons Criminal Records check, however this was discussed with the registered manager who described the decision making process that had been undertaken before employment was offered, other than this the home’s recruitment process was deemed to be robust in terms of protecting service users. Sampling of staff files indicated that since the previous inspection of the home staff have received training in the following area: • Health and safety • Fire safety • Manual handling • Appointed persons first aid • Food hygiene • Adult protection There was also evidence of the home having improved its induction procedure for the inducting of new staff to the home. The Penant DS0000054579.V302298.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, 39 and 42. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service. Service users can expect to benefit from living in a home that is well managed and run. Service users can expect that the home will seek their views about the running of the home and its future development. Service users can expect to be protected by the home’s practice on providing for their health and welfare. EVIDENCE: The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 22 The registered manager has a significant number of year’s experience of working in the care sector, and holds the level registered Managers Award. The manager has overall responsibility for the running of the Penant and its sister home, which is situated just around the corner. The manager was able to provide evidence of undertaking periodic training to enable them to remain current and up to date. The home’s quality assurance process is managed corporately and an audit is carried out twice yearly, the latest audit carried out was sampled, and evidence was seen of the views of service users having been sought. In addition monthly regulation 26 reports are carried out monthly and are provided to the Commission for Social care Inspection. The home’s safe working practices were considered through the viewing of the following safety certificates, which were found to be in order: • • • • • • • • • • Environmental health Inspection record Portable appliance checks Fire extinguisher check record Electrical installation certificate Gas installation certificate Fire alarm installation certificate Copy of fire plan Weekly fire warning record check Record of monthly emergency lighting check Record of last fire evacuation (September 2006). The Penant DS0000054579.V302298.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 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 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 1 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 24 Yes 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 YA23 Regulation 18 (ci) Requirement The registered person must ensure that all staff receive training appropriate to the work that they are to perform. This relates specifically to the need for all staff to receive training in Adult protection. Timescale for action 28/02/07 2. YA24 23 (2b) The registered person must 28/02/07 ensure that the home is kept in a good state of repair externally. This relates specifically to the need to ensure that the patio area is maintained in a safe condition. The responsible person must 28/02/07 ensure that the home is kept in a good state of repair, externally as well as internally. This relates specifically to the condition of the laundry facilities based in outbuildings at the rear of the property. The previous timescale was not met. The previous timescale set of the 30/06/06 was not met. 3. YA30 23 (2b) The Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 25 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 Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Penant DS0000054579.V302298.R01.S.doc Version 5.2 Page 27 - 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!