Inspection on 11/08/05 for Wolverton Court

This inspection was carried out on 11th August 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wolverton Court 19/03/07

Wolverton Court 01/03/06

Wolverton Court 24/01/05

Wolverton Court 16/08/04

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Insight - Eastchurch

Southfields

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Dovedale Court

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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 Wolverton Court Alkham Valley Road Alkham, Dover Kent Ct15 7DS Lead Inspector Julie Sumner Announced 11 & 16 August 2005 at 10:00am 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. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Wolverton Court Address Alkham Valley Road, Alkham, Dover, Kent CT15 7DS 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) 01304 825544 High Quality Lifestyles Limited Registered Care Home 8 Category(ies) of Learning Disability registration, with number of places Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2005 Brief Description of the Service: Wolverton Court is a home for people with learning disabilities and communication difficulties who present challenging behaviour at times. The home is owned by the private company: High Quality Lifestyles. The companys philosophy is to support people who have displayed behaviour that has caused them and others difficulty and has limited ordinary/usual kinds of life opportunities by positive guidence and a specialised environment. Wolverton Court is registered to provide accommodation for up to 8 people. At present 4 people live in the home and need a high level of support. It is the companys intention for a maximum of 5 people to live in the home in order to provide a high quality level of support to each individual. The home is a detached property in large grounds situated in the Alkham Valley, which is mid way between Dover and Folkestone. It is a semi rural area and the home provides transport to ensure the service users are able to access facilities in Dover or Folkestone and pursue a variety of activities. The local bus route is on the main road opposite the home. All the bedrooms are single and situated on the ground and first floor and are decorated to suit individual needs and preferences. Communal rooms are spacious and are also furnished to suit the individuals living in the home. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over two days in August and commenced at 10am the first day. Part of the time was spent with service users and staff and the second day was spent discussing the management of the home and documentation. There is an established staff team at Wolverton Court who have spent time with service users and got to know them well. Training has been provided in strategies to encourage communication skills and positive behaviour. Staff demonstrated their skills in this. The deputy manager has been promoted to manager, having had several years experience working in the home and her application to be the registered manager is being finalised. Questionnaires were given out to relatives and visiting professionals to get their viewpoint on the home. All feedback received was positive. Examples of comments were: “I have no criticism of the home. Staff are always helpful and friendly” and “This service provider delivers a quality service and care”. The following methods of inspection and information gathering were used: observing activity in the home, spending time with service users and staff, including having lunch with everyone, some one-to-one discussion and group discussion at different times with staff and some limited interaction with service users, touring the home and reading and discussing policies, plans and records including individual service user plans, medication charts, some staff records including training records and duty rota. What the service does well: Service users are provided with a calm environment that is clean, spacious and clutter free. Staff spend time with service users giving them lots of positive attention and supporting them with different activities. There are support strategies and techniques to prevent challenging behaviour and develop methods of communication and social skills as an alternative to the need for negative behaviour. Where it is indicated in the agreement between the home and the care managers for one or more members of staff to give individual support, this is given consistently. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 6 Plans for support are written to make sure all staff know how each person needs to be guided and what they like to do. Service users receive constructive support from staff to guide behaviour and develop social and communication skills with good clearly written plans. Clear records are kept to discretely measure progress and effectiveness of support in reducing socially limiting behaviour. 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 contacting your local CSCI office. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 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 Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 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) 2 Assessments have been completed for all service users and give a good basis of current needs and abilities. EVIDENCE: Assessments are carried out prior to moving into the home and then reviewed in the home following monitoring of the persons’ wellbeing skill development and behaviour. The assessments are carried out in conjunction with the behaviour support team. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 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, 9 Service users know that their views are taken into account and that their personal goals are reflected in their individual plans and potential risks are managed. Service users receive good support to develop social skills and overcome communication difficulties. EVIDENCE: Service user plans are well designed with clear guidelines for staff. Permission for support with behavioural strategies has been obtained from appropriate medical and psychology specialists. Service user plans are reviewed every six months and more frequently if needs or circumstances change. Records are kept to monitor effectiveness of support and modify the guidelines for support as needed. Information and guidelines in the service user plan relate to observations made to determine needs where communication difficulties have prevented service users actually saying what they want. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 10 Risk assessments are in place for all relevant circumstances and have been designed to provide appropriate staff support when out in the community. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 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) 12, 13, 17 Service users are able to go out with appropriate support and develop skills to cope with and enjoy different opportunities in the community. Service users are supported to go out and exercise to relieve tension and keep fit and healthy. EVIDENCE: All the service users were in the home at different times. Activities were arranged for the afternoon with service users participating in the inspection during the morning and doing home based tasks or spending time out in the garden. One service user has his own car and went out for a drive. Risk assessments for this and required level of staff support all documented. Service users like to go out for regular walks. There are hills at the back of the home that are accessible and provide some good scenic and varied routes. One service user has his own car with a specially adapted harness as he enjoys going out for drives so much. The home also has a minibus to enable everyone to go out at different times. There are plans for service users to go on holiday this summer. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 12 Staff take it in turns to prepare the meals. Service users have the opportunity to assist with some of the preparation in relation to their risk assessment. The menu was varied and service user likes and dislikes were taken into account. Service users were observed to be supported appropriately and sensitively whilst eating their lunch. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 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) 19, 20 Service users are supported to access health and medical services to maintain a healthy lifestyle and receive appropriate treatment when needed. Service users have medication only if necessary to assist with the support given to promote and maintain their health and wellbeing. EVIDENCE: There was evidence of very effective support to investigate and access medical treatment for a service user recently suffering from a recurring medical condition. It had been necessary to overcome communication difficulties and emotional disturbance during investigation, diagnosis and treatment. Staff were supporting with the aftercare, following medical advice and discussed this at the time of the inspection. It is the philosophy of the company to only use medication as a last resort to support control of negative behaviours and this was reflected in the prescribed medication. A monitored dosage system is used. Records were completed accurately. 6 staff who administer medication to service users have recently received medication training. 2 staff are booked on the course. The content of different courses attended was discussed. The most recent course attended was over 3 months and included homework, a written test and observation of administering medication by the training pharmacist. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 14 Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 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) EVIDENCE: Not inspected at this time. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 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, The service users live in a functional and comfortable home that is decorated and furnished around individual needs. A written maintenance and refurbishment plan would speed up the redecoration and repair of areas and replacement of items in the home due to heavy wear and tear. EVIDENCE: Due to the nature of the service there is a high level of wear and tear on the home and maintenance is needed constantly to maintain a pleasant environment for service users. The refurbishment is carried out on a request basis from the home to the company. There is no planned maintenance and renewal programme for the fabric and decoration of the premises. It would be beneficial to plan ahead to prevent areas in the home becoming very worn out before replacement. A recommendation is being made for this. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 17 The kitchen is about to be refurbished and the service users are going on holiday to enable minimum disruption in the home and for the work to be carried out swiftly. All bedrooms have been decorated and furnished to individual preference and are uniquely designed. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 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, 35 Service users benefit from the consistent support of staff who know them well. Staff training would enhance the quality of support provided and provide staff with skills to further increase opportunities to service users. EVIDENCE: Good, supportive interaction was observed between staff and service users. The shift pattern has been designed around assessed needs. At present staff work a shift all through the day so that they are there when service users wake up and assist them to retire to bed in the evening. It has been found that this works well for all concerned. There is documented evidence that incidents of agitated and challenging behaviour have reduced whilst service users have been living at Wolverton Court. The company has a philosophy of positive behaviour support and a plan to develop the workforce by training in this has been designed. Training is considered important but training in general areas of care including mandatory training has been overlooked. NVQ training is being provided. The home has not achieved the target of 50 of the workforce having NVQ 2 by 2005. 4 staff are currently studying NVQ 2 and are working towards this target. The training matrix was viewed. There were several gaps where training had not been provided. Several members of staff have only received induction Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 19 training and training in the safe management of aggressive behaviour. A requirement has been made in respect of this. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 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) 38, 39, 42 The health and safety of service users and staff has not been ensured due to the lack of training provided in safe working practices. EVIDENCE: The staff team were well coordinated and responsive to individual needs. They discussed the practices in the home and were complimentary of the management of the home. Documentation was in place and appropriately completed as required in schedule 2, 3 and 4 with the exception quality monitoring feedback. At present there is no quality assurance audit system in place by the company. The only aspect of monitoring is by the company representative carrying out regulation 26 visits although these have not always been carried out monthly and service user participation is negligible. It was the company’s intention to set this up last year but due to unforeseen circumstances this process was halted. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 21 The training matrix covered all training identified by the company to meet the needs of the service users in the home and indicated what training had taken place. The priority training was the prevention and management of challenging behaviour that had been undertaken by all staff and updates for experienced staff. Overall, very little training had been undertaken and nearly all staff had no up to date mandatory training to ensure safe working practices. Some first aid training had been booked. A requirement has been made to provide all relevant training and mandatory training as priority. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score 3 2 x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wolverton Court Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 1 x x 1 x H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 23 yes 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 24 Regulation 13 Requirement To ensure that service users are not disrupted and distressed by non home based staff accessing office accommodation. a) relocating administrative offices from the home. b) reviewing the use of the office accommodation for training of staff who access the meeting/training room through the service users home. To set up a quality assurance audit system within the company to measure success in achieving aims and statement of purpose of the home based on views of service users and their representatives. System structure and planned implementation to be completed by timescale. Unannounced visits by company representative to be carried out monthly and preferably by someone who is able to give service users with communication difficulties the opportunity to participate. All staff must attend training to ensure safe working practices and ensure the health and Timescale for action 30th November 2005 2. 39 24 (1) (a,b) (2) (3) 31st March 2006 3. 39 26 30th November 2005 4. 35, 42 18 (1) (a) (c)(i)(ii) 30th November 2005 Page 24 Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 welfare of service users. A training and development plan needs to be designed for all staff to include all mandatory and essential training to meet service users needs. Training plan to be provided to the CSCI by timescale. 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 32 Good Practice Recommendations Continue to provide NVQ training and work towards achieving 50 of the workforce having NVQ 2. Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 25 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 © 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 Wolverton Court H56-H05 S23630 Wolverton Court V236399 110805 Stage 4.doc Version 1.40 Page 26 - 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. 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