CARE HOME ADULTS 18-65
The Wimbledon 58 Selsea Avenue Herne Bay Kent CT6 8SD Lead Inspector
Mark Hemmings Announced 9 and 10 June 2005
th th 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 Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service The Wimbledon Address 58 Selsea Avenue, Herne Bay, Kent. CT6 8SD 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) 01227 742969 01227 370909 All About Care Ltd Mrs M Abbott CRH 34 Category(ies) of MD (17) MD(E) (17) registration, with number of places The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: The Wimbledon (the Home) is registered to provide accomodation and personal care for 34 adults (service users) who experience various degrees of difficulty with maintaining aspects of their mental health. Of this number, up to seventeen of the service users may be older people. At the time of the present inspection visit, there were 26 service users in residence, of whom four were older people. The Registered Provider is a private limited company. The Managing Director of the Company is Mr M Todd. Date of last inspection 5 January 2005 Brief Description of the Service: The premises are a large, detached, two storey older property which has been adapted for its present use. To the side of the main building, there are two “chalets” or port-a-cabins, which constitute part of the accommodation provided by the Home. When full, there is provision for seven of the bedrooms to be shared by two people each. In practice, only three of these rooms are used as shared accommodation. All of the other service users can have a single occupancy bedroom. The accommodation for service users is provided on both floors of the main building. Access to the first floor is by stairs. Two of the bathrooms, some of the toilets, the smokers lounge and the laundry are in a poor, or are in a very poor condition indeed. The chalets have long passed their useful life. The Home is situated in a quiet residential area. The nearest shops are within normal walking distance. The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection visit was announced and it took about nine hours to complete over the course of two days. During this time, the Inspector spoke with or spent time with 10 service users. Also, he spoke with the Registered Manager. The Inspector examined various records and he spoke with support workers and with housekeeping staff. The Inspector looked at various parts of the accommodation. This included (by invitation) one service user’s bedroom. The Home continues to provide the service users in residence with the support and assistance they need. Service users say that they remain satisfied with the provision made for them in The Wimbledon. What the service does well: What has improved since the last inspection?
The Registered Manager has introduced an addition to each person’s service user plan. This comprises a concise account of those aspects of the person’s mental health status with which they are most likely to require assistance. This development has been done to better enable support workers to quickly
The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 6 identify a problem situation. so that it can be addressed and resolved in a timely manner. The Registered Manager has strengthened the system used in the Home to ensure that all members of staff are aware of how best to prevent the occurrence of a fire safety emergency. Also, how to respond effectively to one should the need arise. 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 Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 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 Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 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 and 5. Prospective service users are given the information they need to make an informed decision about living in the Home. EVIDENCE: There is a Service Users’ Guide. This is a brochure which prospective service users are given and which outlines the facilities and services provided in The Wimbledon. In addition to this, the Registered Manager speaks with prospective service users to answer any remaining questions they may have. Prospective service users are encouraged to visit the Home at least once before they make a decision about moving in. All of the service users have a copy of the contract of residence. This document gives a suitably detailed account of the terms and conditions in accordance with which the Registered Provider delivers accommodation and care services in the Home. The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 and 10. Service users are confident that their present and future needs for personal care will be met in a reliable and consistent manner. They are suitably consulted about both the assistance they receive and the day to day running of the Home. Service users are supported in taking prudent risks. Service users know that information about them is handled in a confidential manner. EVIDENCE: There is a service user plan for each service user. These documents describe the assistance the service user in question has agreed to receive. The Inspector sample checked several of these plans and he found them to be suitably detailed. Service users say that they are consulted about the contents of the plans and that they are fully involved in periodic reviews of their contents. Service users consider that they receive all the assistance they need. Support workers assist service users in a manner consistent with that described in the individual service user plans. Service users say that private information about them is treated as being confidential. Support workers have a good understanding of how to ensure confidentiality in practice.
The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 10 The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17. Service users have access to a suitably varied range of social and vocational activities. Service users are enabled to exercise their citizenship rights and to respect those of other people. Service users are offered a suitably healthy diet. EVIDENCE: Service users undertake a range of social and vocational activities. Service users say that they are consulted about what they want to do and that staff assist them to access the necessary resources. The Inspector witnessed a number of these events taking place during the course of the inspection visit. Most of these involved service users leaving the Home in order to attend activities in the community. Service users consider their time to be appropriately occupied. Service users are assisted to maintain contacts with members of their families and with friends who do not live in the Home. Service users say that they are provided with good quality meals and that they always have enough to eat. The Inspector took lunch with service users on
The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 12 both of the days of the inspection visit. He noted the meals served to be of a good standard and to be adequate in quantity. The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20. Service users receive assistance and support in a respectful and appropriate manner. Service users are assisted to handle their own medication when this is appropriate. Suitable arrangements are in place to enable staff to retain and dispense medication on behalf of service users. EVIDENCE: Service users say that support workers are attentive to their needs without being intrusive. The Inspector witnessed a large number of occasions on which support workers assisted service users. He noted these events to be characterised by a quiet informality which is consistent with good care practice. Service users who have problems with aspects of their physical health are assisted to seek and to follow the advice of their doctor. Staff keep a tactful eye open so that medical conditions are noted at an early point. The Commission has not received any expressions of concern in relation to the Home from partner agencies such as members of the primary health care team. On a risk assessed basis, service users are assisted to manage their own medication. At the time of the inspection, none of the service users were acting
The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 14 in this manner. The Inspector examined selected aspects of the arrangements used by staff to administer service users’ medication. He found that suitable practices were in place to store medicines and to ensure that service users take them in the manner intended by their doctor. The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 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. Service users consider that their views are listened to and as necessary are acted upon. Service users are protected from abuse, neglect and self harm. EVIDENCE: There is a complaints procedure which explains how service users and other stakeholders can make a complaint about any aspect of the facilities and services provided in the Home. Service users say that they are confident that any matter they raise will receive serious attention and if possible will be addressed. Support workers have a good understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances which might jeopardise the well-being of a service user. Also, they are aware of how to bring such a matter to the attention of the Registered Manager and/or to external regulatory bodies. Service users say that they feel safe living in The Wimbledon and that they trust members of staff to act in their best interests. The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 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 and 30. Some of the parts of the accommodation are specified to a poor or to a very poor physical standard. The accommodation is clean. Service users’ bedrooms are adequately presented. There is adequate equipment in place to enable support workers to assist those service users who experience a measure of reduced mobility. EVIDENCE: Service users say that their accommodation is homely and is familiar to them. The Registered Provider recognises that the physical standard achieved in two of the three bathrooms, in the smokers’ lounge, in the chalets and in the laundry fall very significantly below the minimum which service users have the right to expect. Service users say that they like their bedrooms and that they have all they need in order to use them as bed sitting areas. The Inspector visited one of the bedrooms and he noted it to be finished to a normal domestic standard. The accommodation is kept clean and presentable. The kitchen is cleaned to a hygienic standard.
The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 17 Some of the service users experience a measure of reduced mobility. Suitable facilities are available to support workers to enable them to safely assist these people. The Registered Manager is aware of the need to keep this matter under review. This is so that additional equipment can be obtained should the need arise. The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 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) 31, 32, 33, 34, 34 and 36. Support workers have a good understanding on their duties and they work together well as a team. There is an adequate number of staff on duty. Support workers have the competencies they need and their practice is monitored. Appropriate steps are taken to ensure that only suitable people work in the Home. EVIDENCE: Support workers are provided with a written account of their duties. The staff team is relatively stable. This means that people have got used to working together and that service users know who is going to be around and what they are going to be doing. There are regular staff meetings and support workers say that they are actively consulted about how the Home is administered. There are usually four support workers on duty from early in the morning until tea time, when the evening and night staff come on duty. There are usually three support workers on waking duty at night. The staff roster shows that most shifts are routinely filled. There are no vacant posts in the Home at the moment. Most of the support workers have completed a relevant National Vocational Qualification (NVQ). This means that they have been validated as having the
The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 19 skills they need to respond effectively to service users’ needs for assistance. In addition to this, the Registered Manager provides introductory training for all new support workers and periodically appraises the competencies of existing staff. The Registered Provider arranges for support workers to undertake specific courses in subjects such as first aid and in how to respond to extreme situations. All of the support workers meet periodically with the Registered Manager or with the Deputy Manager to review their work. The Registered Manager and the Deputy Manager have a thorough understanding of how the Home operates in practice. Service users appreciate the way in which they are free to speak with them whenever they wish to do so. The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 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 and 42. The Registered Manager runs the Home so as to reliably provide service users with appropriate assistance. The Registered Provider operates a suitable quality assurance system. The health and safety of service users and staff is adequately protected. EVIDENCE: The Registered Manager has the competencies necessary to enable her to operate the Home in the best interests of the service users. She has almost acquired both of the formal management qualifications prescribed by the Standards. In addition to this, she has attended various training courses. The Registered Manager appropriately establishes a balance between promoting service users’ independence and protecting them from taking undue risks. There are various policies and procedures available in the Home. These are designed to support staff when undertaking their duties. The Inspector noted that support workers are conversant with the principles expressed in these
The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 21 documents. Also, that they carry out their work in a manner which is consistent with their provisions. The Registered Manager maintains various recording systems to assist in the management of the Home. The Inspector examined the accident book and he noted that there were no patterns which indicated the need for him to make any further enquiries. The Inspector also examined the records which the Registered Manager keeps in relation to those service users who elect to receive assistance with the management of their weekly personal spending allowance. The various entries checked were found to be in order. Service users are confident that their monies are administered in an appropriate manner. The Kent Fire Service and the local Department of Environmental Health have not recommended any improvements which remain outstanding. The Registered Manager completes the periodic checks which have to be made to ensure the continued serviceability of the Home’s fire safety regime. The Registered Provider has arranged for all appliances such as gas boilers to be serviced in accordance with the manufacturers’ instructions. The Registered Manager said that there are no significant hazards around the premises which could result in someone having an accident. Also, the Inspector did not notice any such hazards. The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 3 3
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 1 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Wimbledon Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation None 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 None Good Practice Recommendations The Wimbledon H56-H05 S58572 The Wimbledon V224128 090605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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
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