Care Home: 32 Kentish Road

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What the care home does well The home provides a valuable respite service to local people. People who access the service say that staff are kind and they like staying here. They say they can choose how to spend their time and have enough to do. They say they can talk to staff who help them sort out their problems and concerns. Training and support is good and ensures competent and confident staff supports service users. Care plans are regularly reviewed to ensure that people`s changing needs are met. The manager knows how she would like to improve the service and how she will achieve these goals. What has improved since the last inspection? All the requirements made at the last inspection have been met. This includes adding more detail to assessments and care plans; ensuring staff have up to date training to ensure the safety and well being of service users; all policieshave been reviewed and people using the service and their relatives have been given a copy of the home`s complaints procedure. What the care home could do better: No requirements have been made as a result f this inspection, however, a programme of redecoration should be in place and this should include updating the kitchen. CARE HOME ADULTS 18-65 32 Kentish Road Freemantle Southampton Hampshire SO15 3GX Lead Inspector Liz Palmer Unannounced Inspection 8th May 2008 10:45 32 Kentish Road DS0000039603.V361170.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 32 Kentish Road DS0000039603.V361170.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. 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 32 Kentish Road Address Freemantle Southampton Hampshire SO15 3GX 023 80 701227 023 80 772007 nicki.ward@southampton.gov.uk 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) Southampton City Council Mrs Nicola Jane Ward Care Home 7 Category(ies) of Learning disability (7) registration, with number of places 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th May 2007 Brief Description of the Service: 32 Kentish Road offers respite care to adults who have a learning disability. The service is managed by Southampton City Council and can accommodate up to seven service users for pre-arranged periods of respite care. There is a small and secluded garden attached to the home and service users are also able to access the nearby day care services. The building is accessible with bedrooms and bathrooms located on the ground and first floors. The building does not have a stair lift or passenger lift. The service user contribution for an overnight stay is approximately £3.56. 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was an unannounced site visit to 32 Kentish Road by an inspector and took four hours. During the visit the inspector spoke to one member of staff on duty and the manager. A tour of the home was undertaken and included looking at communal areas, including bathrooms, the kitchen, bedrooms and the office. Other information used to inform he inspection was the home’s Annual Quality Assurance Assessment which they provided to us when we asked for it. There were no people in the home during the inspection so we visited the day centre where four people were spoken to. One was currently staying at Kentish Rd and three regularly access the service. What the service does well: What has improved since the last inspection? All the requirements made at the last inspection have been met. This includes adding more detail to assessments and care plans; ensuring staff have up to date training to ensure the safety and well being of service users; all policies 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 6 have been reviewed and people using the service and their relatives have been given a copy of the home’s complaints procedure. 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. 32 Kentish Road DS0000039603.V361170.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 32 Kentish Road DS0000039603.V361170.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): 1, 2 and 5. 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. People who use the service can be assured that their individual needs and aspirations would be assessed prior to moving to the home. People have individual terms and conditions. EVIDENCE: The AQAA states that there is a comprehensive assessment process, which includes a Care Manager’s assessment and an assessment by the manager of the home. Files looked at showed evidence of this and of he involvement of service users and/or their representatives. All people using the service now have individual contracts including the terms and conditions of their contract. All the requirements made at the last inspection for this outcome group have now been met. 32 Kentish Road DS0000039603.V361170.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 and 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. People who use the service have individual care plans and risk assessments that are detailed and clear. People who use the service are involved in their care plans and involved in decisions about their every day life. EVIDENCE: Three care plans were looked at. These are clear, specific to the individual and kept under regular review. There was evidence that people who use the service are involved in this process, as are their relatives, care managers and other relevant professionals. Information such as important relationships likes and dislikes and how to support individuals are written in the plans. Communication needs are detailed for individuals to ensure that those supporting them can understand their needs and wishes. 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 10 Also included are emotional and health needs and evidence of concerns being followed up was seen. People who use the service are supported to take risks and risk assessments are in place and regularly reviewed. Risk assessments are drawn up on an individual basis and the emphasis on independence and positive outcomes supports people to achieve their goals and aspirations. Examples promoting independence and supporting individuality were seen in the care plans. People said they were able to choose how they spend their time and care plans reflect this. 32 Kentish Road DS0000039603.V361170.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, 15, 16 and 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. People who use the service are supported to access a range of educational, social and community activities. Healthy and varied meals are provided with the preferences of people who use the service taken into account. EVIDENCE: From the three care plans looked at talking to staff and talking to service users it is evident that people are supported to make choices about how they spend their time. They are supported to access a range of activities during their stay at the home. They may choose whether or not to attend their usual day centre. During evenings and weekends a range of activities are offered and some may be undertaken on a one to one basis with staff. Care plans detail people’s preferences and their regular social activities. Evidence was seen to show that 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 12 people are supported to do the things they like and pursue their hobbies. People are supported to use the local shops, pubs, cafes and restaurants. People spoken to confirmed that they were involved in the decision making in the home and that there are good activities in the home. They all said they liked staying there and looked forward to their visits. Evidence in care plans showed that people are supported to keep in touch with their families. Some are supported to use the telephone and individual arrangements are in place for this. Healthy and varied meals are provided and people said they enjoyed the meals and some liked helping with the cooking. Details of specific dietary needs are recorded in care plans as well as individual needs and preferences. Meals and meal times are flexible. 32 Kentish Road DS0000039603.V361170.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 and 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. People who use the service are supported to maintain their health and receive personal care in a way that meets their individual needs and preferences. They are protected by the home’s policies and procedures for storing, recording and administering medication. EVIDENCE: The individual needs and preferences of people who use the service regarding their health and personal care are recorded in their care plans. Care plans and daily records show that people get the support they need and that staff respond to any indication that the person’s health or well being is effected. Evidence in care plans shows that emotional and psychological needs are considered individually and the home has good links with other professionals who can offer advice and support. 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 14 People spoken to said there privacy is respected and they feel safe and well cared for in the home. Each person is supported to maintain their health and well being by having the details of their own General Practitioner (GP) in the home. Evidence seen showed that the home will contact GPs if they have any concerns and action is communicated to staff to ensure everyone is aware of any new procedures or changes to medication. The requirement for all staff responsible for administering medication to be trained in administering eyes drops has been met. Medication is safely stored and administered. Procedures and records for this were sampled and found to be secure and accurate. The home has guidelines in place and where appropriate individual protocols are in place. 32 Kentish Road DS0000039603.V361170.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 and 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. People who live in the home and their families are able to express their views and make complaints. Procedures are in place to protect people from abuse EVIDENCE: People who use service and their relatives have all been provided with a copy of the homes’ complaints procedure, as required at the last inspection. Alternative formats are available to those who may be, for example, visually impaired. No complaints have been made since the last inspection. The homes’ AQAA states that they are committed to capturing informal complaints and ironing out issues straight away. People spoken to said they would speak to a member of staff if they were unhappy about anything. The home operates the Southampton City County Council policies regarding Adult Protection and staff are trained in this. There are no ongoing adult protection issues and no complaints about the home have been made to the commission. 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service have a clean, homely and safe environment to live in. Improvements need to be made to the kitchen. EVIDENCE: During the inspection the lounge, dining room, office, bedrooms and bathrooms were seen. All these areas are clean and homely and suitable for the people who use them. The kitchen however, is in need of updating. The flooring is coming up in places and the gap between the cooker and the wall is unsightly and could be unhygienic. The home needs to come up with a program for redecoration and maintenance of the home that includes when it plans to update the kitchen. 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 17 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. 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. A trained and competent and flexible staff team ensures the smooth running of the service. EVIDENCE: The member of staff spoken to during the inspection was confident and competent. They said they enjoyed their work and showed sound knowledge of the individual needs of people who use the service. They spoke about people in a sensitive and positive manner. People who use the service said they liked the staff and got on well with them. The homes’ AQAA states that a standardised training programme is provided to all staff. The manager ensures that all staff receive mandatory training, such as, Health and Safety, Manual Handling, Fire, Food Hygiene and First Aid. New staff receive the a ‘Skills for Care’ standard induction programme. Permanent staff are trained to National Vocational Qualification level 3. Staffing numbers 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 19 have been reduced/increased depending on the needs of service users staying at the home at any given time. Two new staff have been employed at the home since the last inspection and their files were seen to contain all the required documentation, including, an application form, two written references and a Criminal Record Bureau check. The AQAA states that regular supervision takes place and this was confirmed by the member of staff spoken to. Not all records were available to demonstrate this was the case for all staff as the homes’ computer was not accessible during the inspection. The manager confirmed that regular supervision takes place for all staff. 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 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 home is well run and the health and safety of people who use the service is promoted. The best interests and views of service users are part of the overall and day-to-day development. EVIDENCE: The manager of the home has achieved National Vocational Level 4 and the Registered Managers’ Award and is registered with us in respect of this home. People who use the service are consulted about the daily running of the home and are involved in decision-making, shopping and house hold tasks. The 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 21 AQAA states that Regulation 26 monitoring visits take place regularly and the manager meets monthly with her manager. Feedback from people who live in the home confirmed that they feel able to talk to the manager and staff at the home and expect their views to be listened to and acted on. Throughout the AQAA the home manager has highlighted areas in need of improvement and strategies to address these. The manager has also addressed all the improvements we asked for at the last inspection including ensuring that all aspects relating to the health and safety of service users have been reviewed and updated. For example, ensuring fridge temperatures are recorded, hand washing facilities and ensuring water temperatures are safe. 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 X 5 3 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 3 35 3 36 3 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 3 X 3 X 3 X X 3 X 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 32 Kentish Road DS0000039603.V361170.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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