Inspection on 09/06/05 for The Summers

This inspection was carried out on 9th June 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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Summers 27/09/08

The Summers 19/09/07

The Summers 23/08/06

The Summers 23/11/05

The Summers 30/09/04

The Summers 15/06/04

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Insight - Eastchurch

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Seabourne House

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Dovedale Court

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

CARE HOME ADULTS 18-65 The Summers Yeend Close East Molesey Surrey KT8 2NA Lead Inspector Kenneth Dunn Unannounced 09 June 2005 10:00 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 Summers Version 1.10 Page 3 SERVICE INFORMATION Name of service The Summers Address Yeend Close West Molesey Surrey KT8 2NA 020 8979 4689 020 8941 0468 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) Kingston YMCA Care in the Communtiy LTD Mrs Barbara Chater Care Home 28 Category(ies) of LD - Learning Disability (4) registration, with number MD - Mental Dissorder (2) of places PD - Physical Disability (28) PD(E) - Physical Disability - Over 65 (5) The Summers Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. Adults aged over 35 - 65 years of age 2. Physical Disability (28), Physical Disability over 65 years of age (5) 3. The age range of the service users in flat 4 may be from 25 years for respite care 4. Of the 28 service users accomodated, up to 2 may fall within the catergory MD 5. Of the 28 service users accomodated, up to 4 may fall within the catergory MD Date of last inspection 30th September 2004 Brief Description of the Service: The Summers is a large purpose built detached property located near the town centre of West Molesey, Surrey. The service provides a good standard of accommodation and facilities for up to 28 adults with physical disability, some over 65 years and a maximum of 5 service users with learning disabilities. All current bedrooms are single and are set across two floors. All bedrooms sizes exceed the NMS. The home has a private garden and parking for several cars at the front. The service is owned by the YMCA and managed on a day to day basis by Mrs Barbara Chater who is directly employed by Surrey Social Services. The home accommodates both male and female service users. There is only one lift to the upper floor of the home. The Summers Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 hours and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. Mr Kenneth Dunn, Lead Inspector for the service, carried out this inspection Mrs. Barbara Chater was present as a representative for the establishment. A full tour of the premises took place and 15 residents were spoken to during the inspection. The home had a comprehensive statement of purpose, which accurately depicted the services provided by the home. The service plans in place were comprehensive and are reviewed on a regular basis. The home provided a high level of individualised support to service users. This was a commendable part of the home’s operation. The menus provided were appetising and well presented using fresh foods where possible. Links with service users friends and family were well developed and maintained by the operation of the home. Service users’ health needs were well met. The home has a positive and supportive relationship with the local surgery. All staff are trained in the administration of medication. The home has a robust complaints procedure. There have been no complaints received either by the service or by the CSCI in relation to this service. However there is a investigation being conducted in respect of one service user bullying a fellow resident. The home is well maintained and furnished to high standard. It offers spacious and well-equipped accommodation to its service users. The inspector was introduced to two senior members of the YMCA organisation who were conducting a tour of the establishment to meet with service users and staff. What the service does well: The manager and the staff team are committed to providing a safe and homely environment for service users. Service Users are given every opportunity to take part in the day-to-day running of the home and their views are continually sought to improve the services the home provides. Routines in the home are flexible and Service users make choices about how they wish to spend their time. The Summers Version 1.10 Page 6 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Summers Version 1.10 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 Summers Version 1.10 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, 2, 3, 4 & 5 The Summers Version 1.10 Page 9 Residents have the information they need to make an informed choice about where to live. The home has an admission procedure in place that includes a basic needs assessment for an individual and offers the person an opportunity to visit the home. Contracts were in place for residents. However all of the documents must be reviewed to ensure that they accurately depict the true nature of the service and the service users. EVIDENCE: The statement of purpose and service users guide complies with the National minimum Standards. In discussions with the manager it was felt that both documents should be reviewed and changed to reflect fully the service and the service users. The format must be in an appropriate format to allow the service users to access the information they contain. The admission procedure talks about pre-admission assessments that must be carried out and offers trial visits to the home on numerous occasions. The manager must ensure that any potential new admission into the home fully complies with the policies. Therefore the manager must review the policies of admission to ensure that they are fully based upon the National Minimum Standards for Younger Adults specifically standards 2, 3, 4 & 5. The Summers Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9 The service users’ individual plans are clear and comprehensive including details of needs and goals. They also incorporate known or indicated preferences with in depth risk assessments. EVIDENCE: During this inspection the service users were seen to be making clear choices about their daily lives and to be supported by staff as necessary. Service users were seen to be choosing where they went and what they did in the home with confidence. If they wanted assistance with an activity, in one case a service users wanted to go to Kingston to purchase a new watch, they came to a staff member in this case his key worker and asked for assistance, and they organised thing between them. The same service user also went to the bank to pay his bills and withdraw cash for his shopping trip unsupported, he told the inspector that he does this all the time and only needs help when he has to go further than the local community. The inspector was informed by service users that the home holds meetings at least monthly and service users are encouraged to bring forward any issues they have with the service. The Summers Version 1.10 Page 11 The Summers Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15 & 17 The service users have opportunities for personal development, to take part in appropriate activities within the home and in the local community. They are supported and enabled to maintain and develop appropriate personal and family relationships. Meals are well-balanced and varied. Systems are in place to ensure that service users’ rights are respected. EVIDENCE: All Service Users have full and varied activity programmes. Examination of the home’s records confirmed a high degree of personal empowerment and choices in services users daily lives. They were encouraged and supported in the use of community amenities and in maintaining relationships with friends and families. There is one married couple amongst the service users they met and married at the home in addition there is one other couple who are in a long term committed relationship. Both couples informed the inspector that the staff fully support them and respect their choices and ensuring them maximum privacy at all times. Service users attend various day centre and adult education activities. The inspector was informed by the manager that there was a great variety of The Summers Version 1.10 Page 13 community-based activities are available to all service users. The activities programmes seen were individualised in accordance with service users wishes. They were encouraged to pursue individual interests and hobbies. Staff attempt to maintain links with Service Users’ families. Friends are encouraged to be invited to visit the service users. The home has maintained some good family links. There are no restrictions in terms of visiting times. There was evidence in the care plans that service users are supported to be as independent as possible, and are free to make decisions where possible. The service users were free to move around the home consistent with individual risk assessments in place. The Summers Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Personal care and healthcare support and assistance is planned and was provided in a respectful and sensitive manner. Sound policies and practices are in place for the administration and management of medications. EVIDENCE: During this inspection all personal care and support was carried out in privacy with the doors closed. One service use received a visit from her doctor while the inspector was touring the home staff were observed to discreetly assist the resident into their own room in order to protect the service user’s privacy and dignity during the consultation. All service users are registered with a local GP and referrals to other health care professionals are obtained, as necessary, from the GP surgery. Some of the service users were making the most of the sun and were helped by staff to protect their skin with sun screens this was observed to be relaxed and the 4 service users appeared comfortable with the staff while this was happening. The Summers Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 There is a clear and effective complaints and compliments procedure in place. Complaints information is available to residents. Complaints are responded to appropriately and staff are aware of that residents must be protected from abuse, neglect or harm. EVIDENCE: Policies and procedures are in place to ensure that service users are safeguarded from harm or abuse. The home has a copy of the Surrey Multiagency Protection of Vulnerable Adults procedure, which is available to all staff in the office of the home. Regular residents meetings are held so that views are listened to and acted upon. Residents were aware that if they are unhappy they could complain to a number of people including the CSCI inspector. Residents are very vocal and were heard to be talking to staff about what they like and anything that they do not like. A log is kept of all complaints and compliments received into the home. At the time of this inspection an investigation into alleged bullying by one service user to another was being investigated. At the time of the inspection a planning meeting had been organised to try and develop a strategy handling the situation. The manager must ensure that the conclusion must be referred back to the CSCI local office. The Summers Version 1.10 Page 16 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, 29 & 30 The location and layout of the home is suitable for it’s stated purpose. It is accessible, safe and well-maintained. The home was found to meet service users’ individual and collective needs in a comfortable and homely way. However there is still an ongoing issue with the call bell system, which still fails to provide a safe method of summoning help for some of the service users. In addition the excessive heat in the kitchen area has become an issue again. The manager must also ensure that adequate ventilation is provided for catering staff. EVIDENCE: The fixtures, fittings, furniture and décor are all to a high standard with consideration being given to the client group to be accommodated at the home. On the day of inspection the home was seen to be warm, bright and clean with a homely atmosphere. The service users’ individual rooms have all been highly personalised with the service users’ own belongings and mementos. The provided furniture was seen to be suited to the needs of the service users. The rear garden is not large and mostly laid to lawn with secure fences and side access gate being locked, however it does offer privacy and security. Service users told the inspector that they regularly sun bath out in the garden The Summers Version 1.10 Page 17 as it is such a sun trap, another service user has tables set out for her collection of plants. During this inspection service users were seen to be entering communal rooms and their own rooms with confidence and at will. It was clear that the service users have a sense of ownership over their home whilst at the same time respecting the other service users’ personal rooms. The home has been fitted with a call bell system to ensure that the service users can get assistance if and when they require. The call bell system however is not designed with some of the service users in mind specifically those with restricted use of their hands. It is essential that all service users have full access to assistance at all times therefore the manger must ensure that this situation is rectified and suitable aides are provided to the service users. On the day of the inspection the kitchen area was very hot with little or no ventilation. It is recommended that fly screens are fitted to all external doors and windows or alternatively the kitchen should be fully air-conditioned. To ensure the well being of the staff required to work in the kitchen area. The Summers Version 1.10 Page 18 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) 33, 34, 35 & 36 All interactions observed between staff and service users evidenced a high degree of respect and skill in working with the individual service users at the home. Staffing is kept under review to ensure that the needs of the service users are met at all times. The home has a comprehensive staff training programme which incorporates all areas needed to ensure, as far as reasonably possible, that service users are in safe hands at all times. EVIDENCE: In house training, specific to each individual service user, is provided to all new staff in order to allow the care to be provided as stress free as possible for the service users. The staff displayed their skills, knowledge and understanding in all interactions observed. The inspector was informed that National Vocation Qualification (NVQ) in care at level 2 was on target. The organisation has a commitment to ensure that every member of staff is offered the opportunity to take part in NVQ training. Staff member spoke very highly of the benefits of NVQ training and that it defiantly assisted them in there daily lives with the service users. Documented, formal supervision takes place on a six weekly basis with all staff and the home has a yearly appraisal system in place. The Summers Version 1.10 Page 19 The Summers Version 1.10 Page 20 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 There is good leadership and consistent direction to staff in this home to ensure that Service Users receive consistent quality care. The manager is fully aware of the needs of the Service Users in the home and as such is able to communicate this to staff through regular staff meetings and individual supervision sessions. EVIDENCE: All interactions observed between the manager, staff and service users at this inspection evidenced an open, positive and inclusive atmosphere. All required written policies and procedures are in place at the home. Recommendations have been made that the manager review the policies to ensure that they support the practise. In areas staff were exceeding the policies and therefore providing a better level of care however the written documentation did not reflect this. All necessary health and safety checks are carried out by the staff at the home with documentary evidence inspected of routine fire practices and evacuations, fire, gas and electrical safety certificates. The Summers Version 1.10 Page 21 Staff were noted to receive training in matters of health and safety and ample information was available to advise staff as to safe practice, including lifting and the handling of corrosive materials. There is a Health and Safety procedure in place. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 2 2 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 The Summers Score x 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Version 1.10 Score 2 3 3 3 3 3 2 Page 22 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 2 x The Summers Version 1.10 Page 23 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 YA2, 3 & 4 Regulation 12(2&3), 14()(d), 18(1&3), 19(5)(b), Schedule 3.1(a) Requirement The manager must ensure that the homes policies for the introduction of all potential service users are fully robust, and meet the needs of the service and the service users. All policies must be based on the National Minimum Standard for Care Homes for Younger Adults. The manager must ensure that the conclusions and feed-back from the ongoing VAP investigations are referred back to the CSCI local office. All service users must be able to access the call bell system, ongoing works must be fully completed. The kitchen area must be properly and professionally ventilated. Timescale for action 30/07/06 2 YA23 10(1), 12, 13(6), 37(g) 16(1), 23(1 & 2) 13, 16 & 23 Schedule 3.3. 30/07/05 3 YA24 30/07/05 4 YA30 & 42 30/07/05 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 Good Practice Recommendations Version 1.10 Page 24 The Summers Standard 1. The Summers Version 1.10 Page 25 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Summers Version 1.10 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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