Inspection on 20/03/08 for Welcome Home

This inspection was carried out on 20th March 2008.

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

Welcome Home 27/02/09

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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 Welcome Home Marrow Cliff View Gardens Warden Bay Leysdown Kent ME12 4NH Lead Inspector Geoff Senior Unannounced Inspection 20th March 2008 10:30 Welcome Home DS0000070025.V359530.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 Welcome Home DS0000070025.V359530.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. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Welcome Home Address Marrow Cliff View Gardens Warden Bay Leysdown Kent ME12 4NH 01795 510884 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) Mr Neil Tucker Mrs Susan Holton Care Home 4 Category(ies) of Learning disability (0) registration, with number of places Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 4. This was first inspection visit following registration Date of last inspection Brief Description of the Service: Welcome Home is a four-bedroomed bungalow, recently converted to provide a residential service for up to four adults, either male or female, with learning disabilities. The bungalow with its ¼ acre garden is situated in a quiet residential part of the small town of Leysdown-on-Sea and is a short walk only from the beach. The service is offered within a regime and environment that respects individuality and aims to offer a home for life in a safe and stimulating environment. Service users are supported by a committed and well-informed staff group. Reported fess are in the range £708-£849. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Welcome Home included an unannounced visit to the home that was undertaken on 20/03/08. Time was spent talking with the Provider, the Manager and with staff on duty. The opportunity to discuss with the service users, their experiences and opinions of the home was limited by their involvement in activities and their inclination and ability to communicate or not. Observations indicated that they were settled in the home, were comfortable in the company of staff and had plenty to do. 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 were observed and noted. The premises were viewed and a range of records was inspected. The comments of family members in phone conversations subsequent to the site visit were generally supportive of the service offered. The comments include: ‘The home listens to what we (parents) have to say.’ ‘Very happy with the placement and my daughter’s progress.” “Positive staff attitude to service users and families.” Family were invited to suggest any changes or improvements. None were suggested. Not all NMS were inspected at this visit. Unless noted, only the core standards were inspected in each outcome group. The quality rating for this service is 1 star. This means that people who use this service experience adequate quality outcomes. What the service does well: Welcome Home provides a caring and supportive environment for the service users. There is a good range of activities available based on individual and collective needs. The staff work positively with the service users assisting them to communicate their needs and develop greater levels of independence and confidence. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 6 There are opportunities for staff development and avenues for opinions and concerns to be voiced. Similarly, service users are encouraged to participate in the decision-making processes. 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4. Quality in this outcome area is adequate. Service user needs and aspirations are identified and supported once in placement. As the home does not purport to be for emergency or short notice placements, the management needs to ensure that relevant information is obtained and assessments are undertaken prior to admission. Some service users had the opportunity to visit the home, to meet existing staff and residents and find out about the lifestyle they could expect to experience. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The admission process intends to offer the prospective service user and the home ample opportunity to obtain and assess information before deciding whether this is the right placement. It was reported that any prospective service user would usually be subject to an assessment and introduction Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 10 period. This would be to determine the mutual suitability of the placement and to ensure that the individual’s needs can be appropriately supported. The most recent admissions however were short notice and the opportunity for protracted assessment was denied. The manager is ensuring that relevant information is obtained without delay and without detriment to the individual or the service offered. One relative spoken with confirmed that they and the service user were able to visit the home and meet with everyone. A pre admission assessment was undertaken but the manager has kept in touch to clarify and confirm findings and discuss any new issues. Prospective service users and their representatives are offered access to written information to inform them of the service in the form of a statement of purpose and service users guide. The manager is aware of the need for clear and simple communication and is revising some documents to include pictorial entries. The provider and manager are clear that only people whose needs can be met and who will gain from living in the service will be offered a permanent place. There are staff development opportunities ensuring that the team has or will develop the skills necessary to deliver appropriate support. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is adequate. The care planning system is under review and would benefit from additional ‘person centred’ information and guidelines relating to social, educational and therapeutic goals and aspirations. Risk assessments are undertaken in order that service users can participate in activities with the appropriate level of support and supervision. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager acknowledged that the service is still in a ‘settling in’ period from both a physical and administrative perspective. The service users have been in residence only a matter of weeks and she is reviewing all records and documentation. As a matter of priority she is ensuring that all care plans are up to date and relevant. It was agreed, in discussion with the Manager, that Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 12 the care plan documentation, which has a good level of descriptive terms for support processes and staff guidance, would benefit from ‘person centred’ information and guidelines relating to social, educational and therapeutic goals and aspirations. Risks are viewed positively by the home and assessments are undertaken in order that the service users may participate in activities with the appropriate level of support and supervision. It clear from discussion and observation that service users are being supported in making decisions about their daily lives with regard to activities, outings, routines and food choices. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is good, The Home provides a range of therapeutic and leisure activities based on personal needs, wishes and interests. Service users are offered a varied diet and range of meals designed to meet individual needs and preferences. Links with family and friends are encouraged and maintained This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff at the home are working positively with the service users to establish interests, likes and dislikes. The service users are supported to attend and enjoy a range of social, and therapeutic activities. The Manager has recently Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 14 initiated a community based social and fun club that meets once a week. The service users may attend if they wish. If an activity is identified as particularly attractive or potentially beneficial to an individual then every effort is made to achieve the goal. The Service User group is not long established but the staff are already aware of food likes, dislikes and preferences. Meals are provided mainly based on these wishes, but also taking into account the need for a reasonably balanced diet. Visitors are encouraged and made to feel welcome at the home. Restrictions are placed only in accordance with the wishes of, and convenience to, the Service User. A relative confirmed that the staff keep in contact with families to update them on progress and changes. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is adequate. Service users are treated with respect and their privacy respected. Healthcare monitoring and medication systems are in place to promote the well being of service users. The viability of service user involvement has yet to be assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the service users require assistance with aspects of their personal care and hygiene. The management ensures that the staff are instructed and supervised to provide this thoughtfully and sensitively. Preferences for the way personal care is provided and support needs that are specific to the individual are documented in the service user files. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 16 The healthcare needs of service users are monitored and addressed. The home has developed positive relationships with the local healthcare agencies that provide support and advice. Specialist staff are consulted as required and the outcome of visits noted in case files. Medication storage and records are adequate for the needs of the home. Medication administration records were clear and up to date. The home has procedures in place for dealing with medicines. It was reported that staff that currently administer medication are deemed, by the manager, to be competent by experience and qualification. The manager expressed an awareness of issues relating to independence and medication. She has yet to undertake an assessment to see if service users could be more involved in the management of their medication. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is adequate. Systems are in place to protect service users, as far as possible, from the risks of harm or abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was reported that, in addition to input on the NVQ2 training, protection of vulnerable adults training is offered, but is yet to be completed by staff. Staff spoken to indicated an understanding of issues relating to the protection of vulnerable people. They are aware of their role in ensuring people living in the home are protected from abuse in all its forms and that they are the service users main key to having their views heard. In conversation with family members it was apparent that they had been made aware of the appropriate procedures and would happily approach staff and management if they had any concerns or complaints. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is good. Service users at live in homely, comfortable and seemingly well-maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a spacious communal lounge/ dining area, a suitably equipped kitchen, communal toilet and bathroom. A manager’s office, adjoining the entrance hallway, is also suitably equipped with lockable filing cabinet for confidential files, phone/ fax, PC and internet access. The home is a one storey detached property situated in a quiet residential area. Local amenities are within walking distance as is public transport. The home does however have it’s own transport. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 19 The home presents as a comfortable, varied, clean, and well-maintained environment in which to live and work. All service users have their own bedroom with en-suite facility, decorated and personalised according to taste. Communal areas provide for relaxing, activities and mealtimes. The garden is still being developed although there are areas laid to lawn with a paved terrace for sitting. The laundry area is in need of attention to the wall and floor covering and a general clearing of non essential items. The manager is aware and has planned for in the maintenance programme. Written confirmation was received that maintenance checks and certification are satisfactory and up to date. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35.Quality in this outcome area is adequate. There are sufficient staff on duty to support the service users. clear about their roles and responsibilities. Staff are Staff are encouraged and supported to complete the induction process. They need to attend statutory training courses to further develop skills and expertise. The management indicated a good awareness of the need to ensure adequate checks are made on all potential staff to determine suitability and protect the Service Users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users have only been in residence for a maximum of five weeks so the staff team is still establishing itself. The Manager has appointed four support staff, two of whom have commenced duties. Two are awaiting clearance on police checks. Each of these persons has relevant past experience and the recommended NVQ at level 2, in Care. Staff files seen indicate that appropriate checks are carried out prior to commencement of duties. Staff are Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 21 supported through the induction process, that reportedly embraces the Common Induction Standards from Skills for Care, and six weekly 1-1 supervision. Statutory and service specific training has been planned for the staff members who have not already attended prior to their appointment at Welcome Home. Part-time cooking, cleaning and laundry hours have been factored in, together with separate night care workers. Staff were observed interacting with the service users in a friendly and non patronising manner. They indicated an understanding of the service users’ needs and responded in a patient, calm and proactive manner. It was reported that day time staffing levels are adequate for the demands of the current group. This would be reviewed and revised should the need arise or the size of the group change. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is good. The home appears to be well run in an inclusive manner that allows for service users and staff to contribute to the daily life and routine. The home is supportive, encouraging the ongoing development of the service users. There are systems in place to promote the well-being and safety of the service users and staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 23 The manager appears to be a well informed and well organised individual who seeks to ensure that service users are consulted as appropriate. Staff seem well informed and encouraged to contribute to the development of the service. It appears from discussion and observation that the Management is approachable and supportive. They operate an open door policy and meet with staff individually and collectively on a formal and informal basis. An open and inclusive atmosphere appears to already have been established within the Home. The Registered Provider is fully involved in the day-to-day operation of the home and undertakes both support and maintenance tasks. There is as yet no formal quality assurance system in place. Parents confirmed in conversation however that they felt fully informed, involved and consulted on any matters that impact upon the experience and quality of life for their relative. The health, safety and welfare of service users, staff and visitors is addressed in induction and training and through written guidance. Information in the pre inspection questionnaire indicates that the maintenance checks and certification are satisfactory and up to date. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 24 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 2 3 x 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 3 x Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 25 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 New service users are admitted only on the basis of a full assessment undertaken by people competent to do so, involving the prospective service user, using an appropriate communication method and with an independent advocate as appropriate. The registered manager develops and agrees with each service user an individual Plan which may include treatment and rehabilitation, describing the services and facilities to be provided by the home, and how these services will meet current and changing needs and aspirations and achieve goals. The registered manager and staff encourage and support service users to retain, administer and control their own medication, within a risk management framework, and comply with the home’s policy and procedure for the receipt, recording, storage, handling, administration and disposal of medicines. The registered person ensures that there is a staff training DS0000070025.V359530.R01.S.doc Version 5.2 Page 26 2 YA6 3 YA20 4 YA35 Welcome Home 5 YA23 and development programme which meets the Sector Skills Council workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users’. Staff to complete statutory training. Staff to be trained in protection of vulnerable adults. Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Welcome Home DS0000070025.V359530.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!