Care Home: 147 Cheriton Road

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 147 Cheriton Road 147 Cheriton Road Folkestone Kent CT19 5HE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Lawrence     Date: 0 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: 147 Cheriton Road 147 Cheriton Road Folkestone Kent CT19 5HE 01303850475 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Nicola.masters@hft.org.uk Home Farm Trust Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 8 The maximum number of service users to be accommodated is 8. 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: Learning disability (LD). Date of last inspection Brief description of the care home 147 Cheriton Road, is located on a busy main road running through a pleasant residential area of Folkestone. The home is close to a mainline rail station and is on a public bus route; it is close to a range of leisure and educational facilities and is within walking distance of the main town shopping area. The home is registered for 8 adults with learning disabilities and offers a spacious and comfortable environment. The premises consist of a large semi detached period property still retaining some original features. The accommodation ranges over four floors with a basement providing space for a laundry facility and additional storage. The kitchen, dining room, and lounge are Care Homes for Adults (18-65 years) Page 4 of 25 Brief description of the care home located on the ground floor, with access to the rear garden via the dining area. Bedrooms are located on the first and second floors, and are all single occupancy. Access to these floors is by stairs only so the home is unsuitable for anyone with a mobility problem. We were informed that the current fees are £645 to £1315 per week but this is very much about levels of support needed. Care Homes for Adults (18-65 years) Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection visit was notified to the home the day before to ensure that there would be someone available and started at 10.15 and finished at 15.15. We (the Commission for Social Care Inspection, CSCI) looked at various records in the home and also used information sent to us by the manager before the visit. This was the Annual Quality Assurance Assessment (AQAA). Information from the previous inspection carried out on 16 January 2007 and the annual service review undertaken in February 2008, was also referred to. We observed the residents who live at the home, noting how they reacted to staff and how relaxed and comfortable they were within the home. A tour of the building was undertaken and this included residents rooms. We made observations of staff interacting with, and supporting residents. We spoke to staff including the manager and staff on duty. We spoke to some of the residents, both individually and in Care Homes for Adults (18-65 years) Page 6 of 25 small groups. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents individual aspirations and needs will be assessed. Evidence: We looked at the records for the most recently admitted resident. Although this person was known to the home they still carried out a comprehensive assessment. Information was gathered from the care manager and the placement where the client was living. The manager and another experienced member of staff went out to meet the new person. The assessment used covers a range of subjects, reflecting the kind of support needed and included risk assessments as well as the wishes of the individual such as attending church and other aspects of living in the home. Care Homes for Adults (18-65 years) Page 10 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that their changing needs will be noted in their individual, person centred plans and that they will be supported and enabled to make decisions and take risks to live as independent a lifestyle as possible. Evidence: We looked at individual records for three people living at 147 Cheriton Road. Home Farm Trust (the owning organization) is now using a web based system for assessments and care planning called Support Planning Assessment and Recording System (SPARS) and the manager showed us how this works. It ensures that records are up to date and comprehensive. All the current residents have had their assessments updated within this system which also incorporates relevant aspects of the Mental Capacity Act. The care plans seen were very individual and were person centred. Through the AQAA the manager identified that all the people living at 147 Cheriton Road were able to communicate their wishes and those we spoke to said they are involved in their support planning. We saw that plans are regularly reviewed. Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: We noted examples of residents making choices and decisions and this was underpinned by clearly written support plans which focussed on enabling residents to do things for themselves as much as possible. The plans contain sections such as support needed to make decisions and plans and support needed with personal care to promote independence. We observed residents making choices such as what to cook for supper, whether to spend time alone in own room and whether or not to go on an outside activity. We observed staff members always asking and checking with people to make sure they were doing what they wanted. The support plans contain goals to be achieved which the resident has identified with their key worker. These contain information highlighting what the benefits would be for the individual and there is also a breakdown of the goal into smaller steps which identifies timescales and who is to do what. The support plans have risk assessments which are very much about enabling people to do things as safely as possible rather than stopping people doing things which might have a risk attached. We saw one person ironing, another making hot drinks and the records also showed that some residents go out independently. Care Homes for Adults (18-65 years) Page 12 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities and involvement in the local community, as well as support for personal relationships will be provided for residents in an individual way. They will benefit from having a healthy diet and will be encouraged and enabled to develop skills relating to preparing meals. Evidence: The records seen which included care plans, daily records and activity planners, showed that the people living at 147 Cheriton Road have appropriate activities and social events, both inside the home and within the community. Examples noted included voluntary work at a local charity shop (four people); swimming; trampolining; horse riding, pottery classes; attending the gym; going to church; art sessions; college courses; employment at the head office site (two people); karaoke evenings at a local pub; yoga and massage. Not everybody does the same things and the activity Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: planners showed that things are very individualised. The manager explained that each Sunday evening people go through their planners (in diagramatic format for those who wish) and confirm what they want to do the following week. This was confirmed by residents. Some residents travel independently using their own bus passes. Residents told us that they have opportunities to go away on holidays and one example of this was a week in Majorca. Two people attend church independently and one goes with support occasionally. We noted examples of residents being supported to maintain relationships with friends and relatives. One person is supported to keep in contact through writing letters. One person said she enjoyed seeing her mum. We were informed that family members are invited to social occasions. The atmosphere within the home is based on promoting independence (each person also has an individual folder called working towards independence) and emphasizing that the people living there have rights. The manager noted in the AQAA and during the inspection visit, that people living at 147 Cheriton Road have rights to make decisions and choices and to be treated as an individual. We saw this put into practice by the way staff interacted with residents. The records seen showed that the menus are varied and nutritious. There are three separate menus in the house. This is because two people do their planning, shopping and preparation together, with a certain amount of support; two others are similarly together with a different level of support and the others, although involved in choosing meals, are cooked for. There are separate food storage areas and vegetable racks to further encourage and enable people to be as independent as possible. One person said I do my own lunch and tea. We observed one person working out what was still needed for a meal and planning to go to the supermarket nearby. The manager told us that people needed opportunities to prepare meals otherwise they would lose skills they had gained through college courses. He has compiled a menu selector folder with illustrations to assist peopl in making choices. The dining room is attractively furnished and decorated. There is a large table so everyone can sit together. Care Homes for Adults (18-65 years) Page 14 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by the homes policies and procedures regarding medication and their physical and emotional needs will be responded to. Their preferences and requirements for support are respected. Evidence: The care plans contained lots of information about the support people need, as well as prefer, making it clear to staff how this should be done. The key worker system is used to ensure this is all up to date. Residents health care needs are clearly identified within their individual plans entitled health assessments and health action plans, which also indicated that they were regularly reviewed. There is also a fact sheet for any emergency admission to hospital but we were informed that this is being updated to the taffic light system which provides health staff with information which is essential as well as useful and desirable. Each person has a medication profile as well as specific information about how an individual might prefer to take their medication. The records seen showed that healthcare professionals are accessed by residents both routinely and as required. Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: Medication storage is individual and the records seen were appropriately completed. One person self-medicates and staff are working with another person to see if this is possible for them too. Staff have received training regarding medication and as noted above where relevant there is specific guidelines about how individuals prefer or need to take their medication. Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents views are listened to or ascertained, and acted on. Evidence: There is a complaints procedure in place and the manager explained that it is available in different formats and they have tried to ensure that residents are able to understand. Two residents told me who they would talk to if they had things they were unhappy about. The complaints procedure was also made available to people outside the home. The key worker system and the residents meetings also provide opportunities for residents concerns to be heard. There are policies and procedures in place regarding adult protection such as the disclosure of abuse and bad practice (whistle blowing) and the management of residents finances. There are also regular audits of residents finances. One of the residents told me that this had happened recently. The AQAA contained information that staff receive training in vulnerable adults protection and recognition of abuse, communication awareness, awareness of behaviour that challenges, advocacy and empowerment. One member of staff confirmed this and the records of other staff and the staff training matrix on display also reflected this (see also Standard 35). Two staff members who we spoke to were very clear about their responsibilities to protect people living in the home. Care Homes for Adults (18-65 years) Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home which is homely and comfortable as well as clean and hygienic. Evidence: The home is very attractively decorated, creating a bright and comfortable atmosphere with its stylish touches such as plants and candles. This included bathrooms and toilets. It is close to local amenities and public transport. One resident told us about using a bus pass and travelling independently and staff told us that others do also. Residents kindly showed us their rooms which were equally well decorated and furnished and very individual. Laundry facilities were satisfactory and staff have received training in infection control and food safety. The house was clean and fresh at the time of this visit. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sound recruitment procedures and training already provided and training planned, will have a beneficial impact on residents. Evidence: We observed staff interacting with and supporting the people living at 147 Cheriton Road. They were polite and respectful and gave people time to respond or make a choice. They demonstrated through their actions and language an understanding of and commitment to enabling people to be as independent as possible. Four of the six staff have achieved a national vocational qualification at level 2. Home Farm Trusts procedures for recruitment are thorough and include application forms, interviews, criminal record bureau checks, references and terms and conditions of employment. Each person has a copy of the general social care councils code of practice. We saw training and supervision records and the programme of planned training and this all reflected that Home Farm Trust takes training seriously. Staff spoken to confirmed they had opportunities to do various courses. Each person also has a professional passport devised by the organization to monitor roles and responsibilities as well as achievements. Care Homes for Adults (18-65 years) Page 19 of 25 Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well run home and their health and safety is promoted and protected. Evidence: The manager has now been in post since June 2007 and is new to HFT. He has experience in providing care services for individuals with challenging behaviour, autism, learning difficulties and complex needs and has held a senior position for four years accompanied by NVQ level 3 promoting independence in care and is currently completing his NVQ level 4 in care. He informed us that his application for registration would be submitted in the near future. Home Farm Trust has a quality assurance system which includes sampling individuals care planning as well as internal yearly audits which result in action plans which can be made available on request. The move towards person centred planning and reviewing, as well as the key worker system in place underpins the ethos of the provider in looking at how services are performing at all times. There are regular managers Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: meetings also. There is also a residents forum (Speak Out Group) which supports residents to comment on the organization. Surveys are sent out regularly. The manager said that Home Farm Trust reviews its policies and procedures on an annual basis but in the AQAA completed for this inspection some of the dates against policies are more than a year old so they may need to be re-dated. The AssessNet tool is used to record risk assessments as well as recording accidents and incidents. The fire safety checks were properly recorded and a spot check on some of the maintenance and service checks showed them to be appropriate and up to date. There are relevant policies and procedures in place and the records showed that staff have the appropriate health and safety training. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - 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!