Inspection on 15/12/05 for Ulcomb House

This inspection was carried out on 15th December 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 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

Ulcomb House 25/06/07

Ulcomb House 10/03/06

Ulcomb House 17/03/05

Ulcomb House 29/06/04

Ulcomb House 24/03/04

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

CARE HOME ADULTS 18-65 Ulcomb House 24 London Road Sittingbourne Kent ME10 1NA Lead Inspector Graham Cummings Announced Inspection 15th December 2005 09:30 Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 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 Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 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. Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ulcomb House Address 24 London Road Sittingbourne Kent ME10 1NA 01795 428447 01795 410877 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) Mrs Brenda Joyce Tyler Mr Robert William Tyler Mr Anthony Ian Vallis Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age of residents: Residents shall be over 16 years of age to 27 years of age on admission. 17th March 2005 Date of last inspection Brief Description of the Service: Ulcomb House is a Registered care home providing 24 hour care and support to young people with learning disabilities. It is part of Cartref Homes group and has policies and procedures which underpin good practice. The home is staffed by a House Manager, Team Leader and 9 care staff. Ulcomb House is situated on the outskirts of Sittingbourne. The home is close to a train station, many leisure and adult education facilities and local shops. The home has it’s own transport. Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Announced Inspection was carried out on the 15th December 2005. The Inspector met with the House Manager Debby Baldock and the Team Leader Amanda Tyler and explained the new report format and planned the inspection process. The inspection consisted of looking at the completed Pre inspection Questionnaire, 2 Care Manager, 1General Practitioner, 1 Health and Social care Professional and 2 Relative comment cards, discussions with the House Manager and Team Leader, speaking with staff and 5 Service Users, touring the property, viewing 2 bedrooms with Service Users accompanying the Inspector, looking at 5 care plans and 2 Service User files. The Inspector found that the Requirements from the last inspection had been addressed, the care plans were clear and well written with individuals Strengths and Needs, Behaviour Management and comprehensive Risk Assessments. The environment is clean, homely and well furnished. Service Users spoken to informed the Inspector that ‘they were very happy at the home’ ‘I like living here’. Staff spoken to confirmed that they were well supported and enjoyed working at the home. The Inspector was concerned that the House Manager had little to no input on prospective Service Users or selection of staff. The Inspector left the home with no concerns for the health, safety or welfare of the Service Users and complimented the House Manager on quality of service provided. What the service does well: What has improved since the last inspection? The home has actioned the Requirements fro the last inspection covering implementing staff supervision and training. Training carried out since the last inspection includes N.A.P.P.I., LDAF, 1st Aid and Medication, 4 staff are completing their NVQ level 2, 3 staff are on NVQ level 3 and the House Manager is completing Level 4. The Registered Manager for the company Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 6 supervises the House Manager and the House Manager and Team Leader carry out staff supervision. The home has refurnished the lounge, redecorated and carpeted 2 bedrooms and purchased a new television, video and C.D. player. 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. Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 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 Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 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): 1,2,4,5 Prospective Service Users have the information they need to make an informed choice and their needs are assessed. Service Users can visit the home prior to placement and are given a written contract if the placement is confirmed. EVIDENCE: Following the initial contact and information from the enquirer the Registered Manager carries out a pre placement assessment and if this confirms that the placement can proceed a visit to the home is arranged, if this goes well a placement date will be made. The Inspector was concerned that the House Manager was not involved in this process. The House Manager has the responsibility of running the home on a daily basis and is best placed to make sure that the needs of the prospective Service User can be met by the staff team and the home. The Inspector looked at 2 Service User files and both contained a written contract that was signed by the Service User. Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 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): 6,7,8,9 Service Users have an individual care plan. Service Users make decisions and informed choices about their life within the home and it’s running with assistance from staff. Service Users are encouraged to take risks as part of an independent lifestyle. EVIDENCE: The Inspector looked at 5 care plans and found them to contain detailed information about behaviours and strategies for dealing with them, the plans also included risk assessments and the individuals ability to make decisions and informed choices about their personal lives and the running of the home. Due to the needs of the Service Users the home has a high number of staff on duty to participate in 1 – 1 activities with Service Users in the community. The care plans seen showed that they were regularly evaluated and were signed and dated. Each Service User has a key-worker allocated to them, these can be changed at any time if everyone is in agreement. Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 10 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 Service Users have opportunities for personal development. Service Users take part in appropriate local activities and are involved in the local community. Service Users have appropriate family contact. Service Users rights and responsibilities are respected. Service Users are offered a healthy and nutritious diet. EVIDENCE: All of the Service Users attend colleges in the local area ranging from 1 day to 4 days a week, the courses attended cover Numeracy and Literacy, English, Maths and Life skills. Service Users go out into the local community accompanied by staff and assist in the purchase of the homes food that is based on a menu produced by Service Users. Visits by family to the home are all by arrangement so that Service Users can be made aware that it is going to take place, all Service Users know that their families are fully informed of their behaviours and that some visits going ahead are dependent on this. Two Service Users attend church on Sundays with a member of staff. Service Users prepare and cook the meals in the home with the assistance of staff, this is all part of their individual life skills program. The Service Users spoken to all indicated that they were involved with the choice of menu and that they took Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 11 turns to prepare and cook the main meals. Service Users are responsible for the cleaning of their own rooms and participate in keeping the communal areas tidy and welcoming. All of the Service Users have keys to their rooms and staff don’t enter without knocking or being invited in. Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 12 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): 18,20,21 Service Users receive personal support in the way they prefer. Service User who self medicates are protected by the homes policy and procedures. Service Users are treated with respect relating to their illness. EVIDENCE: All Service Users are fully involved in the making of their care plan and set out how they would like to be treated and how the support they need is provided, Service Users family, Care Managers and the homes staff are also involved in this process. There is only 1 Service User that self medicates and this is carried out in line with the homes policy and procedures, the medication is stored in weekly amounts in a locked cupboard within the Service users bedroom that is always locked if he is no in it, the Service User takes his medication in front of a member of staff and then signs to say that they have taken it. Service Users all have families who would take decisions regarding the care they should receive relating to serious illness or death. Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 13 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): 22,23 Service Users views are listened to and acted upon. Service users are protected from abuse, neglect and self-harm. EVIDENCE: Service Users have regular meetings to discuss the running of the home and to plan future activities and events, they are also able to raise any issue relating to the running of the home or behaviour of other Service Users both positive or negative. The home has not received any complaints since the last inspection, the complaints procedure paperwork needs to be change the inspection name from NCSC to CSCI. The home has robust policies and procedures regarding Adult Protection, the House Manager is to check that the new guidelines and protocols issued by Kent County Council have been checked and any changes implemented on the homes policy and procedures. The Inspector suggested that staff should attend a training course on Adult Protection in the near future. Service Users spoken to said that ‘staff were always available to talk to’. Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 14 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): 24,25,26,27,28,29,30 Service Users live in a homely and safe environment. Service Users bedrooms meet their needs and promote their independence. Service Users have sufficient bathroom and toilet space to meet their needs. Shared space complement Service users individual rooms. Service Users have the specialist equipment they require. The home is clean and hygienic. EVIDENCE: The Inspector thought the home was welcoming clean and tidy, it was well decorated and furnished. The home has recently purchased a new 3 piece suite and carpet for the lounge a new compact disc player and television. The home has also replaced 2 bedroom carpets and purchased new furniture for them, redecoration to other areas has also taken place. The Inspector viewed 2 Service User bedrooms and found them to furnished, decorated and containing many personal items that included family pictures, paintings, television, C.D players, videos and 1 Service User also had a computer. The bedrooms are on 2 floors and each floor has a bathroom and toilet that is adequate to meet the needs of the Service users, downstairs the communal space includes 2 lounges, a dining area and kitchen. One Service User has a frame that they use to assist them walking longer distances outside the house, the frame is not used indoors. The home had a relaxed and friendly atmosphere. Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 15 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): 32,33,34,35,36 A competent and effective staff team supports Service Users. The home’s recruitment policy could be improved. Trained staff meet the needs of Service Users. Staff are well supported and supervised. EVIDENCE: The Inspector did not view staff files but was informed by the House Manager that they all contained the requirements set out in Schedule 2 of the Care Homes Regulations 2001. The House Manager was very clear in stating that the staff knew their roles and responsibilities within the home and supporting and ensuring that Service User needs were met. The staff team meet regularly to discuss the running of the home and raise any issues relating to the needs and behaviours of Service Users and how they could improve the service and level of support and care being provided. Although the staff files weren’t viewed the Inspector and House Manager did discuss the process of recruitment, the Inspector was concerned that the House Manager has no input to the selection and interviewing of staff employed by the company, especially as they have the best knowledge of the staff teams strengths and needs and of the Service User needs. Staff have access to regular training, 8 staff are currently completing their N.V.Q’s level 2/3, Adult Protection training needs to be accessed in the near future. The Inspector when speaking to a member of staff was informed that they were receiving regular supervision and was able to access management support at all times. The House Manager and Team Leader are responsible for the staff supervision. Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 16 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): 37,39,42,43 Service Users benefit from a well run home. Service Users’ views underpin the running of the home. The health, safety and welfare of Service Users are promoted and protected. Service Users benefit from competent and accountable management. EVIDENCE: On the evidence available, the Inspector would agree that Service Users live in a home that is well run and managed in the best interests of the individuals living there. Service Users views are included in the day to day running of the home, this includes full participation in the making of the menu, shopping, activities and content of the care plan. The House Manager carries out the responsibility of running the home on a daily basis and is supervised by the Registered Manager who is also responsible for a number of other homes within the company, the Registered Manager has little involvement in the day to day running of the home but is part of the management support structure for staff. Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 17 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 2 X 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ulcomb House Score 3 X 3 3 Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 3 DS0000024037.V262792.R01.S.doc Version 5.0 Page 18 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 YA2 Good Practice Recommendations That the House Manager who is responsible for the day to day running of the home is fully involved in the pre placement assessment and participates in the decision making of any placement into the home. That the complaints form be updated to replace NCSC with CSCI That the House Manager who is responsible for the day to day running of the house is fully involved in the interviewing and recruitment of staff to work in the home That the home arrange for staff to attend an Adult Protection training course in the near future. 2. 3. 2 YA22 YA34 YA35 Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Ulcomb House DS0000024037.V262792.R01.S.doc Version 5.0 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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