Inspection on 28/07/06 for The Sands

This inspection was carried out on 28th July 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 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 15/11/07

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 Geoff Senior Unannounced Inspection 28th July 2006 09:30 The Sands DS0000023111.V299431.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.V299431.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.V299431.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Sands Address 40 Lower Sands Dymchurch Kent TN29 0NF 01905 795088 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) Lothlorien Community Ltd Tina Gillard Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2006 Brief Description of the Service: The Sands is registered to provide care and accommodation for up to three people who have a learning disability. Ms Tina Gillard is the manager in day-today control of the home. At the time of the inspection there were two staff and the Manager on duty and three people in residence. The Sands is a chalet style detached bungalow located on a private residential road close to the centre of Dymchurch. The accommodation is provided on two floors. All of the service users have their own bedroom. The garden area is well kept and access is suitable for the service users. Dymchurch has a selection of shops, cafes and entertainment particularly in the summer months. Local transport facilities are close by as well as the sea with a large sandy beach. The reported fees are £833-1597 per week. The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was undertaken on the 28th July 2006. The inspector met and spent time with the manager, and spoke generally with the staff on duty. The opportunity to discuss the service users’ experiences and opinions of the home was limited by their involvement in other activities and inclination to communicate with the Inspector or not. Those that did respond indicated that they liked the home and staff and had plenty to do. The inspector was able to observe throughout the visit, the staff’s attention to the service users’ needs, their patient, friendly and respectful manner and their treatment of each service user as an individual. The Inspector viewed the premises and inspected a range of records. Subsequent to the visit, the inspector was able to speak with and note the comments of family members and care Managers of service users. The responses were generally supportive of the service offered but also included areas for consideration; to widen the experiences and development of the service users. They confirmed inclusion in the planning and review process and opportunity to voice opinion. This is noted in the text of the report. What the service does well: What has improved since the last inspection? Medication training has been attended. The Manager has completed NVQ level 4 care and management and attained the RMA. Improvement and repairs to the property have been initiated. The service users day programme is no longer confined to one site. This has reportedly improved choice and the opportunity for socialising. The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 6 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 Sands DS0000023111.V299431.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 Sands DS0000023111.V299431.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 at least once during a 12 month period. 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. There is a system in place for undertaking pre-admission assessments of prospective service users and an understanding of the need to ensure compatibility with the existing resident group Staff showed a good understanding of service user support needs. Positive relationships were observed between staff and service users. EVIDENCE: The Service user group is generally well established with no recent admissions. Interested parties would be given the opportunity to visit, meet and spend time with the existing residents and staff and view the accommodation. The company admission process would then be initiated. This includes gathering information from all relevant parties before a decision is made about the permanency of the placement. Every effort is made to ensure that the move to The Sands would be appropriate, mutually beneficial and support needs could be met. The Sands DS0000023111.V299431.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Service user plans are clear, accessible and identify the needs of the resident group. Staff have a good understanding of resident’s rights and Service users are enabled to make decisions affecting their daily lives. Risks are assessed positively EVIDENCE: Service user care plans contain detail on physical and social needs, health care, medical information and behavioural guidelines. Service users family and representatives are encouraged to be involved in the formulation of care plans and participate in the regular reviews. The manager was reminded to ensure that reviews and assessments are dated and signed. The service users are able to verbalise opinions and are consulted whenever appropriate and possible. There is a structure to the weekdays but routines remain flexible. Decisions are made and choices determined on a daily basis. The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 10 Staff were observed interacting with the service users in a friendly and nonpatronising manner and efforts were made to include them in any interactions. The management undertakes and records where potentially hazardous activities are identified or planned so that service users can participate in chosen activities with appropriate support. Risk assessments are reviewed every three months. The Sands DS0000023111.V299431.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Service users’ days are, for the most part, occupied with things they like to do. Staff need to ensure these remain relevant to the developmental needs of the individual. Daily routines promote individual skills and responsibilities. Service users are involved in the choice and preparation of a varied and balanced menu. EVIDENCE: A written programme of activity is on file. The programme includes individual, group, in house and community based activity. There is a balance of social, educational and physical activity. Two of the programmes include independent living skills training. Daily records confirm involvement or give reason for nonimplementation of the programmes. Information received during the course of the inspection suggested that an extension of the programme, to encourage The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 12 evening activities, may benefit some individuals. The home has use of a 7 seater car for transporting service users to and from trips out and social venues. The Inspection Officer spoke with two service users. One enjoys a considerable amount of freedom and spends his days walking and taking photos. The other was very enthusiastic about his activities and looks forward to all of them The Sands DS0000023111.V299431.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 at least once during a 12 month period. 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 Service users are treated with respect and their right to privacy respected. Healthcare needs are kept under review and appointments with health care agencies attended as required. Medication systems and storage were satisfactory and up to date. EVIDENCE: Service users are treated with dignity and respect and levels of privacy are maintained. Service users choose and wear their own clothes. Healthcare needs are monitored and issues addressed. Appointments are made where necessary and service users are supported to attend. The home operates a monitored dosage system of medication administration. The arrangements for storage and records appeared satisfactory and up to date. There are no self-medicators although one service user is working towards managing his medication in the near future. 6 staff have undertaken the ASET level 2 cert in managing and safe handling of medicines. The Manager also undertakes a competency assessment for each staff member. The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Service users views and concerns are listened to and acted upon. Systems are in place to promote and maintain protection from abuse. EVIDENCE: There is a ‘company’ complaints procedure in place. The Manager reported that she operates an ‘open door’ policy and service users are encouraged to interact and voice concerns and ideas to staff at all levels. The Manager confirmed that policies relating to Adult protection, whistle blowing and restraint and guidelines available to staff. The manager reported that all staff have attended Adult Protection training. The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The premises appear to be generally well maintained, clean and hygienic. The home provides a comfortable environment in which to live and work. The planned improvements to the kitchen and laundry facilities now need to be completed. EVIDENCE: At the time of inspection the house appeared to be clean and tidy. Décor and furnishings in the communal and private areas were of generally good standard. A Plans and finance for new kitchen approved. At the time of inspection visit the home appeared to be clean, tidy and free of undue odours. There is a generally good standard of décor and furnishings in the communal and private areas. The Inspector was pleased to note a number of improvements which include: new boiler, new shower with temp control and no mould!. The Sands has a homely feel and observation at this and previous inspection visits noted that service users and staff appeared to be comfortable The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 16 in their surroundings. It was reported that the Kitchen, due for complete refurbishment, has had plans and finance approved. The garage is still to be divided and altered to become a day-care room and laundry. The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment practices provide for the protection of service users. Staff are supported to access training courses to enable them to work more effectively with the service users. The staff team is well supported and supervised by the management and is clear about its roles and responsibilities. EVIDENCE: There is a positive and mutually supportive team working a rota that ensures sufficient members of staff on duty at the home during the day at the home or supporting various activities. Staff are encouraged and supported to attend statutory and service specific training courses as well as NVQ care at appropriate levels. The management have indicated in the past, a good awareness of the need to ensure adequate checks are made on all potential staff to determine suitability and protect the Service Users. Recruitment/induction and probation procedures are in place and are generally followed. The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is good. 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 appears to be promoted and protected EVIDENCE: It appeared from discussion and observation that the Manager is approachable and supportive. She operates an open door policy and frequently meets with staff individually and collectively on a formal and informal basis. An open and inclusive atmosphere appears to have been established within the Home. The Inspector was assured that the service users views are actively sought in all matters relating to their lifestyle and daily routine at the Home. Service user and staff meetings are a regular feature and service users are encouraged to voice their opinions at any time. The home is regularly visited by a The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 19 representative of the organisation not directly involved with its management and reports submitted in accordance with Regulation 26. The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 20 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 2 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 2 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.V299431.R01.S.doc Version 5.2 Page 21 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. 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 YA30 Good Practice Recommendations The NMS requires that laundry floor finishes are impermeable and these and wall finishes are readily cleanable An extension of the activity programme, to encourage evening activities, may benefit some individuals 2 YA11 The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Sands DS0000023111.V299431.R01.S.doc Version 5.2 Page 23 - 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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