Care Home: 248 Brompton Farm Road

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What the care home does well Service users are enabled to make choices with support from a well-trained confident staff team. Staff have developed meaningful ways to help service users to express their preferences by using pictures and objects that they understand. These individually tailored communication methods support service users to make their needs understood. Service users each have had an annual holiday, which they have helped to choose. Service users benefit from being offered nutritious, varied and balanced meals, which they have helped buy, plan and prepare. The home has its own transport for the benefit of service users to access the wider community. What has improved since the last inspection? Staffing levels have improved since the last inspection and ensure that service users have consistent access to community activities. The lounge has been redecorated and new carpet fitted, making a very pleasant environment for the service users. Service users bedrooms have also been redecorated and they chose their own colour schemes. All the newly decorated rooms are attractive and provide a very pleasant environment for the service users to spend their time in. A new bathing aid has been provided, following advice from a health care professional, to meet service users` needs. What the care home could do better: The home continually self monitors its performance and has identified some quality areas that it is currently working on to develop further for the benefit of service users. At the last inspection, the organisation indicated plans to redesign the communal space to create more room for service users. This is not now going to happen. The home does continually monitor service users` needs and the manager indicated that if the communal space did not meet service users` needs, the organisation would take action to address it. CARE HOME ADULTS 18-65 248 Brompton Farm Road 248 Brompton Farm Road Rochester Kent ME2 3NP Lead Inspector Christine Grafton Key Unannounced Inspection 28th November 2007 10:00 248 Brompton Farm Road DS0000064374.V352555.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 248 Brompton Farm Road DS0000064374.V352555.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. 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 248 Brompton Farm Road Address 248 Brompton Farm Road Rochester Kent ME2 3NP 01634 290327 F/P 01634 290327 brompton.farm@theavenuestrust.co.uk glebe.house@theavenuestrust.co.uk The Avenues Trust Ltd 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) Jennifer Ann Smith Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 2006 Brief Description of the Service: 248 Brompton Farm Road is a semi-detached two-storey property with three single bedrooms, off road parking facilities and a rear garden. It is situated in a residential area of Strood, Rochester and is on a bus route. Strood town centre is approximately two miles away. Local shops are approximately ½ mile away in Wainscott. The home has its own motor vehicle. The home currently provides care and accommodation for three service users and is staffed by a manager and team of support workers, who work a rota that includes one person on ‘waking’ duty at night. 248 Brompton Farm Road is managed and run by Avenues Trust, while the Health Authority owns the property. The fees for each service user are set during the assessment process and are determined according to individual needs, the level of support needed and the staffing numbers required. Information provided by the manager in November 2007 indicates that the fees for the home range from £1,335.34 to £1,166.16 per week. 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report takes account of information received since the last inspection, including a visit to the home. An unannounced visit took place on 28th November 2007 between 10.00 hours and 14.35 hours. The visit included talking to the manager and staff on duty, plus observing service users and their interactions with staff. Some records were viewed and all areas of the home were seen. Observations of the home routines, activities and staff practices were made. At the time of the visit there were three service users living at the home. The atmosphere in the home was welcoming and relaxed. The manager submitted an annual quality assurance assessment prior to the visit and the information provided was useful in the planning of the visit and has been used in the assessment of this service. What the service does well: What has improved since the last inspection? Staffing levels have improved since the last inspection and ensure that service users have consistent access to community activities. The lounge has been redecorated and new carpet fitted, making a very pleasant environment for the service users. 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 6 Service users bedrooms have also been redecorated and they chose their own colour schemes. All the newly decorated rooms are attractive and provide a very pleasant environment for the service users to spend their time in. A new bathing aid has been provided, following advice from a health care professional, to meet service users’ needs. 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. The summary of this inspection report can be made available in other formats on request. 248 Brompton Farm Road DS0000064374.V352555.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 248 Brompton Farm Road DS0000064374.V352555.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their individual aspirations and needs are assessed and will be met by the home. EVIDENCE: Although no new service users have moved into 248 Brompton Farm Road for a number of years, all current service users have had their needs comprehensively assessed by the Avenues Trust. These assessments have been followed up by appropriate action; such as changes to service users’ living arrangements so that two service users who used to share a bedroom now have their own rooms. The organisation’s admissions policy states that all service users’ needs would be assessed before a place is offered. The Avenues Trust has a development manager to assist service users with moving into a new service, or moving from an existing service. 248 Brompton Farm Road DS0000064374.V352555.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users benefit from having holistic person centred plans, which have been put together with their involvement and take into account their assessed needs, wishes and aspirations. EVIDENCE: All three service user plans were viewed and seen to include: holistic profiles, daily routines, a weekly plan, risk assessments, communication systems and health records. Information about service users is presented in a very positive and sensitive style that is easy to understand, comprehensive and detailed. The person centred plans (PCP’s) together with the home’s daily records and discussion with staff and the manager indicate that goals set and action plans are followed through. The plans are regularly reviewed on an ongoing basis and formal reviews take place every six months. Each service user has a 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 10 path/map in their bedroom in pictorial format so they are able to see how far they have to go before a goal is reached and what needs to happen next. Service users attend the Learning Disabilities Forum run by the local council and the organisation’s Our Say Team to help make decisions. Service users are assisted with their personal finances and records are kept. Each service user has a ‘communication passport’ that specifies the pictures and symbols, or objects of reference to be used to aid communication. The use of these forms of communication was observed throughout the visit and used in a positive way by staff to enable the service users to make choices. The service users were seen to respond well to the methods of communication used and to participate in their chosen activities. Risk assessments are in place for all identified risks with clear instructions for staff. Since the last inspection, risk assessments have been drawn up in pictorial format to enable service users’ involvement. 248 Brompton Farm Road DS0000064374.V352555.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by a staff team that have worked hard to develop meaningful communication systems and enable them to access a range of leisure activities in keeping with their wishes. Service users benefit from being offered a healthy diet, which respects their needs and wishes. EVIDENCE: Observations during the visit and records seen show that staff have continued to develop person centred communication systems with service users to enable them to make choices about their daily routines, their leisure pursuits and activities. Discussion with staff and daily records seen confirm that improvements have been made since the last inspection to ensure that 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 12 community based activities take place as stated in each service user’s person centred plan. The home has its own transport for the benefit of service users, which is used together with other forms of public transport to access the wider community. During the visit, two service users and two staff members went out to a local sports centre to use the hydrotherapy pool. Other community based activities include: attendance at adult education centres, a local activities programme for people with learning disabilities (known as MAPS), discos, trampolining and ice skating. All service users have been on their annual holiday for this year. Staff confirmed that the holidays had been planned over a period of time with service users’ involvement. Discussions with staff and records seen showed that service users are encouraged to go shopping and help plan and prepare food, if this is their wish. Service users are involved in the daily routines of the home and encouraged to participate with the weekly household tasks, such as: doing their own laundry, cleaning and loading and unloading the dishwasher. The menus are decided during the weekly service user meetings. Staff use a folder with pictures of different meals and visual aids to help service users make choices. Food likes and dislikes are recorded in the person centred plans and staff confirmed their awareness of these. Discussion with staff also confirmed that nutrition is constantly considered and healthy eating encouraged, with healthy fresh foods provided and new menus regularly tried out. The lunchtime meal was observed to be a relaxed, unhurried occasion. 248 Brompton Farm Road DS0000064374.V352555.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users can be confident that they will be supported with their personal care in a way they prefer and will receive good health care. Service users benefit from a safe system of medication administration and storage. EVIDENCE: Service users’ plans contain holistic personal and health care assessments and a record of preferred daily routines. The detailed information recorded, together with discussion and observations made during the visit indicate that all identified healthcare needs are followed up. Health records show that service users have regular appointments with routine and specialist health services. Medication storage and administration records were seen in discussion with the manager. Records include staff signatures and detailed guidelines for 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 14 administering individual medications. Medication is stored securely and records are well maintained and up to date. At the last inspection a requirement was made to ensure that staff have received appropriate medication training. The manager stated that all staff do medication training as part of the mandatory training provided by Avenues Trust. Staff training records indicate the dates staff have completed medication training, but there were no records to show what the training covered and the manager could not confirm if it conforms to the specification of the National Minimum Standards for Younger Adults standard 20.10. The manager said she has done a training course for assessing medication and does annual competency medication assessments for all staff. 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their views and concerns will be listened to and acted upon and they will be protected from abuse and neglect. EVIDENCE: The home has a pictorial complaints system, which is easy to understand and displayed on the notice board in the hallway. The home’s annual quality assurance assessment (AQAA) indicates that there is also an audio version of this. The AQAA shows that there have been two complaints received in the past twelve months, both of which were resolved within 28 days. A compliments and complaints book is kept by the visitors’ book in the entrance hall that indicates any issues raised are taken seriously and actioned where necessary. The book also contained several compliments from visiting professionals and visitors to the home. Since the last inspection opportunities sessions have been introduced where staff discuss things that service users have expressed an interest in and any particular dislikes, as they become known, which are then recorded in their person centred plans to ensure that all staff are made aware. Records of these meetings show outcomes and actions for the next session. Service users attend the local Learning Disability Forum and the Trust’s Our Say Team. All of these things provide opportunities for service users to identify any things that might be troubling them and any follow action is then recorded. 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 16 Staff receive training on adult protection as part of their induction. Where service users require support regarding their behaviour, clear guidance is contained in their person centred plan. Service users’ body language, facial expressions and actions towards staff indicate a relaxed manner. 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 17 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, 28 & 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. This home, whilst small, provides service users with a comfortable, homely environment that suits their current individual and collective needs. Service users have benefited from the recent redecoration of bedrooms and lounge areas. EVIDENCE: The home was seen to be clean and comfortable for service users. Since the last inspection, the lounge/diner has been redecorated and new carpet fitted, creating a pleasant environment. Service users were fully involved in choice of décor and colour scheme. Bedrooms have also been redecorated in colour schemes chosen by the individuals. Bedrooms are highly individual and personalised according to the service user’s wishes. One room, although very small, has been made to look particularly attractive by the new décor, with use of colour, sensory objects, mirrors and personal items. The space has been 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 18 well utilised to accommodate appropriate furniture and fittings and it was clear that the service user is happy with their room. Since the last inspection, the bathroom has been assessed by an occupational therapist to see if it meets service users’ needs and a swivel bath seat obtained at their recommendation. Service users also have the choice to shower if they wish, using the over bath spray. This currently meets the service users’ needs and therefore the requirement from the last inspection is met. A requirement was also made at the last inspection to look at ways of providing more communal space for service users as the lounge/diner is used for relaxation, activities and visitors. Everything takes place in this room, including the staff record keeping and discussions. There is a sliding door to separate the dining end that can be used for privacy. The manager indicated that the Trust has no plans to extend the home, as it is looking at long-term options that might include reallocating some services to suit individual needs. This could involve moving to another property at a future date. Therefore the requirement has not been carried forward. A recommendation was made at the last inspection that the brick walls and concrete floor in the down stairs toilet be upgraded to create a warmer and more homely feel. New flooring has been laid in the utility area, which is safe and hygienic. The toilet walls remain the same. The manager feels that to plasterboard the walls would bring the room in and reduce the space for service users. 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 19 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users benefit from the well-trained, enthusiastic and supportive staff team at this home. The home’s recruitment procedures and training programme support service users and staff. EVIDENCE: Rotas seen indicate that staffing numbers are appropriate to the needs of the service users. Rotas are planned to take account of service users’ individual activities. The home was adequately staffed at the time of the visit, with an overlap in shift patters to enable service users to go out on their community activities. Discussion with the manager and staff indicate that improvements have been made since the last inspection and the requirement set has been met, which has benefited service users. The home’s annual quality assurance assessment indicates that all staff that work in the home hold their national vocational qualification (NVQ) in care level 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 20 2 and that any new staff attend a mandatory training programme as part of their induction. Staff training records and discussion with staff indicate that a range of mandatory and service specific training is undertaken and annual refresher courses are completed. Staff confirmed that this enables them to effectively support service users, who can then benefit from being cared for by a competent, confident staff group. The main staff files are kept at the Trust’s head office. The manager keeps some staff records that indicate appropriate checks have been completed prior to any new person starting work in the home, including criminal records bureau (CRB) checks and protection of vulnerable adults register (POVA), providing service users with appropriate safeguards. 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 21 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, 38, 39 & 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care of service users is enhanced by a staff team that is led by a competent and experienced manager, who ensures that the home is run well. Service users can be confident that their views underpin self-monitoring, review and development of the service. EVIDENCE: The manager has several years experience of working with people with learning disabilities in both a support worker role and at a management level for the past two years. Observations at the visit, records viewed and discussion with staff have again confirmed judgements made at the last inspection that the manager ensures the home delivers an effective service 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 22 user led service. Observations showed that she is approachable and inclusive in her management style. It was clear from records and observations that service users are consulted regarding meals and activities and regular individual reviews are undertaken. The home’s quality assurance assessment indicates that as well as seeking feedback from service users in the opportunity sessions and their PCP review meetings, annual questionnaires are sent out to seek views from friends, families, health professionals and other organisations involved in the service. Records seen confirmed that their views are taken into account and acted upon. Information taken from the home’s quality assurance assessment, discussion with the manager and a tour of the home indicate that it is being maintained appropriately. 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 23 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 2 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 x x 3 x 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 24 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. Refer to Standard Good Practice Recommendations 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local 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 248 Brompton Farm Road DS0000064374.V352555.R01.S.doc Version 5.2 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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