Inspection on 15/11/07 for The Sands

This inspection was carried out on 15th November 2007.

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 Sands 28/07/06

The Sands 07/02/06

The Sands 07/10/05

The Sands 18/01/05

The Sands 23/08/04

The Sands 26/02/04

The Sands 18/12/03

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 Sands 40 Lower Sands Dymchurch Kent TN29 0NF Lead Inspector Wendy Gabriel Key Unannounced Inspection 15th November 2007 09:10 The Sands DS0000023111.V352453.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 Sands DS0000023111.V352453.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 Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Sands Address 40 Lower Sands Dymchurch Kent TN29 0NF 01303 875095 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.sands@craegmoor.co.uk Lothlorien Community Ltd Tina Gillard Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th July 2006 Brief Description of the Service: The Sands is registered to provide care for up to three people who have a learning disability. The home is a chalet style detached bungalow, similar to other properties in a private residential road within walking distance of Dymchurch. The accommodation is provided on two floors. All bedrooms are single. There is a small garden to the front of the property and a large well maintained garden to the rear of the home. Limited parking is available off road and some parking is available in the road. Dymchurch has a selection of shops, cafes, churches and entertainment. There is a local bus service. The reported fees are £973.81 - £1646.71 per week. Please contact the provider for further details. The Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The manager was attending a training day and unavailable at the time of the unannounced inspection. The Inspector spoke to the Registered Manager by telephone a few days later for some further information regarding the home. There were two support workers in the home and three residents. Some information was therefore not available at the time due to its confidential nature. However, the staff were helpful and knowledgeable about their roles. The report reflects that some information was not available to be inspected. During the day one person living in the home went out for a walk unaccompanied and staff said this is his usual routine. Another person went out with a support worker and both returned later in time for lunch. One support worker had only worked in the home for a couple of weeks although had worked there previously. A person living in the home had only been there for six days. Staff said that the home was ‘quiet’ and ‘laidback’ to suit the particular needs of the residents who responded to a more relaxed life style. Records were viewed, an accompanied tour of the premises was undertaken and one resident showed his room to the inspector and spoke about his personal possessions in it. Person centred plans for the newer resident had been started and reflected his short time in the home. Some redecoration was needed although the home was clean and tidy. Two recommendations made at the previous inspection had not been met. Staff said the manager was having a ‘change around’ in the office and that currently there were items belonging to the new resident in the office until his room was finished. There was evidence of a new wardrobe being assembled in the bedroom. Later, the Registered Manager confirmed that work had been identified and was due to be completed. The Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The laundry floor is to have an impervious finish. Some redecoration is needed in one bedroom. A bathroom, although clean and pleasantly decorated, could be improved by the removal of a water stain under the taps in the bath and by some tile grouting around the bath. An old fence panel is to be removed from the rear garden. The Registered Manager said that these had all been organised including that once the resident had settled into the home he was to choose the colours for his bedroom. Organised evening activities are limited and staff said that some people get very tired if too much is undertaken. This is to be regularly reviewed especially once the new resident settles into the home, The Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 7 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 Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 8 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 Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have their needs assessed and have the opportunity to visit the home. EVIDENCE: Staff confirmed that prospective residents are able to visit the home. A member of staff said that the new resident had visited a couple of times and had spent an overnight stay at the home prior to moving in. Staff were aware of assessments made for the new resident and that these were ongoing; as once the individual started to settle a better picture would be obtained about needs and choices. An assessment from his previous placement was seen for the new resident and was being used by the staff as the basis of identified needs. The individual person centred plan would be fully completed as information is confirmed. The home operates a key worker system and the new resident will have a member of staff allocated after having some time to settle in. The Sands DS0000023111.V352453.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Person centred plans reflect assessed needs and goals. People who live in the home are given the opportunity to make choices about their lives. Risk assessments reflect individuals’ needs and preferred activities. EVIDENCE: The National Minimum Standards establish care plans as being central to the effective delivery and evaluation of residential care, from which they are used to identify and manage potential risks to health, welfare and safety. The home uses person centred plans to identify personal needs and preferences. People who live in the home have a brief life history recorded as well as personal care needs and lifestyle choices. Staff were very aware of the person centred plans and contents and that risk assessments were recorded. The Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 11 Staff also had a good understanding of individual risk assessments and that in regard to the new resident; the current assessments may alter when he is more settled in the home. There was a good rapport noted between staff and residents. One resident let staff know when he left the home for an unaccompanied trip out. Staff said this was part of the agreement for this particular person. Communication was friendly and encouraging and one resident enthusiastically talked about the staff he liked and the activities he was looking forward to later that day. Staff positively affirmed this with him. Staff were seen to observe the new resident discretely to ensure he was safe and happily occupied. The Registered Manager said in the telephone conversation that she thought the person centred plans were a huge improvement on the old style care plans. She also stated that she had been surprised at how much information the person centred plans had encouraged residents to say about their life styles. The Sands DS0000023111.V352453.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in appropriate leisure activities in the community. Family relationships are encouraged. Residents’ rights are respected. Menus include specialist diets. EVIDENCE: Each resident has an individual activity plan. Currently there is little organised for evenings and staff said that this is because some residents can get very tired especially if they have had organised activities during the day. Staff observed the new resident to find out what activities he enjoys and that when they are sure of his preferences more formal activities may be organised. It is recommended that the home regularly reviews evening activities to ensure residents have the opportunity for activities even on an ad hoc basis. The Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 13 Some activities include meeting other people from local co-owned homes at various venues. The company Christmas party and Carol Concert party are currently being arranged. The home has a vehicle for residents use. Families are welcomed in the home. One resident said that he had chosen his lunch that day and staff said that the menu could be altered to suit different choices. Staff showed a good understanding about the reasons for the special diets that are catered for. The kitchen was immaculately clean and well organised. One member of staff said that the kitchen was fairly new. There was a cleaning rota that was up to date for the kitchen. Temperatures for fridge and freezer are kept. The Sands DS0000023111.V352453.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support is according to choice and assessed needs. Physical and emotional needs are assessed and met. Medication administration procedures protect residents. EVIDENCE: Person centred plans record physical and emotional needs. There was evidence of health care issues being responded to. Staff were knowledgeable about individual residents and reasons for and how to respond to different needs such as specialist diets. Privacy is maintained and the staff supports dignity and respect. One resident prefers to take most of his meals in his room and a dining table and chairs have been provided. Medication is secure and medication policies and procedures are in place. One resident self administers his own medication and is supported by staff who hold the key to his individual storage. Staff undertake safe handling of The Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 15 medication training. Two new staff are due to commence work and will undertake suitable training. All staff receives a competency assessment from the Registered Manager. The owning company undertakes a regular internal audit of medication policies and procedures in the home. The Sands DS0000023111.V352453.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have their views listened to and acted upon and are protected from abuse, neglect and self-harm by staff training. EVIDENCE: Staff confirmed that they receive adult protection training and were aware of abuse concerns that may require them to respond by reporting to the Registered Manager or others. Staff said that the Registered Manager had an open door policy and was approachable. There is a whistle blowing procedure that the newer member of staff was able to understand and a complaint policy is on display in the entrance hall of the home. The Registered Manager is a trainer for CPI and staff receive training for management of violence and aggression. Training certificates seen confirmed this. Residents meetings are held and staff said that they are encouraged to make their feelings known. Person centred plans include likes and dislikes and preferred activities for individuals. The Sands DS0000023111.V352453.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, safe and comfortable environment. Bedrooms suit residents’ needs and promote independence. The home is clean and hygienic. EVIDENCE: The home was clean, tidy and homely. Some redecoration was identified in a bedroom and is to be painted once the new resident has chosen the colours for his room. A bathroom is to have a water stain in the bath removed and tiles grouted. The laundry is in the process of being refurbished and when this is complete the Registered Manager confirmed that impermeable flooring is to be put in place. Bedrooms have items that reflect the individual residents interests. One resident was clearly very happy with his room and pointed out photographs to staff and the inspector. The Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 18 The lounge is large enough for the residents and a member of staff pointed out the sofa and armchairs that are due to be replaced. The rear garden is tidy and can be accessed by residents. A fence panel has been replaced and the old one is to be removed. Plans have been made for this. Residents were seen to freely access different areas of the home. The Sands DS0000023111.V352453.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from the homes recruitment policy and practices and from trained staff. Residents’ benefit from supervised staff. EVIDENCE: Staff files were not viewed at this time as the Registered Manager was not in the home. Staff confirmed that they had to undergo CRB and PoVA checks prior to being employed. The newer member of staff said that he was gradually working through the company induction folder that explains practice and policies regarding the residents and the company. Supervision is also undertaken and staff confirmed that the Registered Manager has an open door policy. Two new staff were due to start work in the week following the inspection. This means the home will be fully staffed. The usual rota is for two members of staff on duty plus the Registered Manager from 9 – 5 during the week. The Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 20 Both staff stated that there is always some training going on. NVQs are promoted and training indicated in the National Minimum Standards is undertaken. Also supplementary courses for specialist interests are taken including for Autism. Certificates were seen for different courses. The Sands DS0000023111.V352453.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a well run home. Residents are protected by the health and safety policies in the home. EVIDENCE: The Registered Manager was not available during the inspection but it has previously been reported that she has undertaken suitable qualifications. The Registered Manager is also a trainer for CPI, PoVA and person centred plans. Staff confirmed she has an open door policy and is approachable. Maintenance checks were not seen at this time. Fire safety practices were recorded and in date. The Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 22 Residents have meetings and the company run a residents forum. Staff said that residents are encouraged to express their views. The Registered Manager said that since using the person centred plans, more information has been obtained from residents about different aspects of their lifestyle and individual choices. Staff did not know if questionnaires were in use for families of the residents. A representative of the company visits regularly and the home is subject to regular internal audits by the company. These include all aspects of health and safety, administration, medication and care planning. The Registered Manager said she welcomed these as it was a useful tool to make improvements in the home. The Sands DS0000023111.V352453.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 3 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 3 26 3 27 X 28 X 29 X 30 3 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 Sands DS0000023111.V352453.R01.S.doc Version 5.2 Page 24 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. 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 YA12 Good Practice Recommendations An extension of the activity programme, to encourage evening activities, may benefit some individuals. 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