Inspection on 15/12/06 for Whiston House

This inspection was carried out on 15th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Whiston House 09/05/07

Whiston House 22/11/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

1 Marten Road

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

CARE HOME ADULTS 18-65 Whiston House Whiston Avenue Bethersden Ashford Kent TN26 3LA Lead Inspector G. Senior Key Unannounced Inspection 15 & 19th December 2006 10:00 th Whiston House DS0000065343.V301249.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 Whiston House DS0000065343.V301249.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. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whiston House Address Whiston Avenue Bethersden Ashford Kent TN26 3LA 01233 820912 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) CareTech Community Services (No.2) Ltd Post Vacant. Acting Manager Ms. Toni Zinzan Care Home 15 Category(ies) of Learning disability (14), Mental disorder, registration, with number excluding learning disability or dementia (1) of places Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate one Service User over the age of 65yrs of age whose date of birth is 30/05/1941. 22nd November 2005 Date of last inspection Brief Description of the Service: Whiston House is a care home that is registered to provide accommodation, personal care and support for up to 15 young adults. It is situated in the village of Bethersden, close to local amenities and approximately nine miles from Ashford. Whiston house is a listed building and the accommodation is arranged over three floors. The home has recently completed alterations to the home to allow for the residents to live in two units of six service users in a more homely environment. There is also accommodation in the ‘coach house’ within the grounds for two residents. There is currently no Registered Manager for the service. Ms T. Zinzan is acting manager in day to day control and has been in post since September 2006. At the time of the visit there were four service users accommodated on each floor and two in the coach house. The reported fees are £650-£1177 per week Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was undertaken on the 15th and 19th December 2006. Time was spent talking with 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 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 after the site visit were generally supportive of the service offered. Not all NMS were inspected at this visit. Unless noted, only the core standards were inspected in each outcome group. What the service does well: What has improved since the last inspection? What they could do better: It was acknowledged that the Acting Manager is relatively new and is working hard to establish the ethos, practice and procedure for the service now being offered. She agreed to ensure that matters relating to consistent staffing and appropriate training in service specific areas such as Person centred planning, autism and medication management are addressed as soon as is practicable. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 6 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. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The admission process aims to ensure that the needs and aspirations of the Service users can be appropriately supported by the home. EVIDENCE: It was reported that there have been no significant changes to the admission process. The ethos of the home remains the same even though the house has been separated into two relatively independent units. There was no indication that assessments were undertaken relating to the revised layout and service. Those seen were for the original placement and subsequent reviews. It was reported that any future prospective placements would be fully assessed by the Manager and the Organisation’s Marketing Dept. to ensure that the identified needs could be appropriately supported in the home. It was suggested that, if the home intends to offer significantly different services on the two floors, the Statement of Purpose and Service User Guide would need to be amended to reflect the changes and differences and a copy forwarded to the Commission. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service Information and guidance on service user’s support needs should be available to staff in an accessible working format. Service users are helped to make decisions affecting their lives. Risks are assessed to promote participation. EVIDENCE: The Manager reported that she has only been in situ since Sept 06 and is currently reviewing and revising a number of areas of administration. One of these is the service user case files. The somewhat bulky arch lever files were seen to contain detailed support requirements of the individual for the guidance of staff. These are, in some cases used in tandem with Person Centred Planning documentation, recently started by the key workers. Staff have yet to receive any training in PCP. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 10 It was agreed in conversation that the service user files should be rationalised. Staff would benefit from having more easily accessible daily working files with relevant support plans and risk assessments. Conversation with staff and residents and observation indicated that staff support the residents to participate, as far as is possible, in decision-making processes. Staff told the inspector that they can discuss ideas for improving the Home and any other general concerns with the manager. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a good range of educational and leisure activity for the service users. Friends and family are welcome at the home and regular home contact is promoted where appropriate. Food preferences and needs are catered for. EVIDENCE: It was evident during this visit that the service users are offered a variety of activities and outings in groups and individually. Structured activity programmes are in place for the service users and the level of participation is recorded. The Manager hopes to expand the programme now that the Martello Day Resource is available to the service users. A member of staff has particular responsibility for day care and activities for the house and has rota pattern to accommodate the role. During the visits a number of service users Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 12 were out at the day centre for set activities on the first day and to attend a Christmas party on the second. The atmosphere in the house on the day was relaxed with a good level of positive interaction noted. Conversation with service user family members confirmed that contact is maintained and visits promoted. There is now a kitchen on each floor so the dietary needs and preferences are catered for on a smaller scale than before. Staff are aware of the individual likes and needs and cater accordingly within a structured but flexible regime. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service user support and health care needs are addressed The Manager needs to ensure that all staff involved with medication have the appropriate level of training and competence, and practice and procedure is in place to minimise risk. EVIDENCE: The key-workers, in conjunction with the management, seek to ensure that service user health and well-being is regularly monitored and any issues arising dealt with promptly and appropriately. The Commission received a number of reports from the home relating to the management and administration of service user medication. The manager reported that all staff have recently undertaken medication training, in spite of which, errors have occurred. These have been investigated by the home and action taken. The manager will continue to monitor practice and ensure that all staff have a level of competence required by the NMS before they become involved in management and administration of the medications. Storage and records seen at this visit appeared to be satisfactory and up to date. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff receive training in the protection of vulnerable people. There are systems in place for the expression and resolution of concerns or complaints. EVIDENCE: Staff spoken to indicated an understanding of issues relating to the protection of vulnerable people. The Manager confirmed that adult protection training is offered by the Organisation. In conversation with service users and family members it was apparent that they would happily approach staff and management if they had any concerns or complaints. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users at Whiston House live in a homely and comfortable environment. EVIDENCE: The Home has been subject to a considerable amount of internal alteration and refurbishment since the last inspection visit. The main house has been divided into two operational units. It now provides ground floor accommodation for six service users. Each bedroom is for single occupation and has an en-suite facility. A sitting room and dining room complete the communal areas. There is also a kitchen, staff office and laundry. The first floor comprises; six en-suite single rooms, sitting room, laundry and two bathrooms. The kitchen, dining room, staff facilities and visitors room are located on the top floor. There is further accommodation in the ‘Coach House’ adjacent to the main house. This was not viewed at this visit. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 16 Overall, the décor and furnishings provide a pleasant and comfortable environment and service users appeared relaxed in their surroundings. It was reported that both service users and staff have benefited from the division of the house and now enjoy the smaller scale, more homely and relaxed atmosphere. Safety and maintenance documentation was not viewed at this visit. The manager agreed to check and confirm dates and certification on the inspection questionnaire following this visit. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. A trained and experienced staff team supports service users but would benefit from additional service specific training. Recruitment practices aim to protect service users. Staff are supported and supervised. EVIDENCE: It was reported that, whilst occupancy levels remain at 4 up, 4 down and 2 in the coach house, there would be at least 6 members of staff on duty (3 on each floor) throughout the day. At night there are 2 waking and 1 sleep-in staff. The manager and day services co-ordinator are also on duty during office hours. The Home has a blend of youth and experience with a senior support worker on duty at all times. It was noted on the duty rota and from comments received that the home makes frequent use of agency staff to cover shortages. It was understood that the same ‘bank’ of staff is used. The Manager needs to ensure that staff levels remain adequate but also that the use of agency does not compromise consistency or unsettle through lack of familiarity. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 18 It was reported that the Organisation offers a good staff development programme. There is an induction and foundation process that staff are supported to work through. There is an ongoing cycle of mandatory training as well as updates and refreshers. The Manager is given a 3 month training prospectus and is asked to nominate staff. It was clear from discussion that the staff would benefit from service specific training that is not yet available on the prospectus. This includes; advanced autism, prader-willi syndrome, person centred planning. Two staff have or are currently training at NVQ level 3, six have, or are doing level 2. Records show that the recruitment procedure and practice aims to protect vulnerable adults. Staff are offered regular one to one supervision. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is currently no Registered manager. The home appears to be well managed and run in the best interests of the service users. EVIDENCE: The home does not currently have a Registered Manager. The Acting Manager is however a trained and experienced individual having been Registered Manager of another home within the organisation. She presented as knowledgeable and enthusiastic and is keen to establish a proactive and efficient service. It was evident that the manager has fostered an open and positive ethos enabling everyone to have his or her say. Staff have been designated areas of responsibility to promote ownership. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 20 Feedback is welcomed via staff/ service user meetings and contact with families. The home is inspected 6 monthly by Head office QA consultant and a representative of the organisation conducts Reg. 26 visits each month. Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 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 2 x 3 x x 3 x Whiston House DS0000065343.V301249.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? no 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 2 3 4 Refer to Standard YA6 YA37 YA35 YA20 Good Practice Recommendations Manager agreed to review and rationalise service user files to manageable working documents. There is currently no registered manager Staff would benefit from service specific training as identified in text The manager should continue to monitor practice and ensure that all staff have a level of competence required by the NMS before they become involved in management and administration of the medications. 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