Care Home: 33 St John`s Church Road

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 33 St John`s Church Road 33 St John`s Church Road Folkestone Kent CT19 5BH The quality rating for this care home is: three star excellent 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: Geoffrey Senior Date: 2 8 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 27 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 33 St John`s Church Road 33 St John`s Church Road Folkestone Kent CT19 5BH 01303252787 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Blythson Ltd Name of registered manager (if applicable) Amy Louise Moffatt Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: 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 The maximum number of service users who can be accommodated is 3. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 27 A bit about the care home 33 St Johns Church Road is a large,Victorian town house situated close to Folkestone town centre 3 people live at the home Everyone has their own bedroom. There is a garden at the back of the house. The home has a car to take people out. It costs about £1500 to £1860 to live there but it would depend on what the persons needs are. Care Homes for Adults (18-65 years) Page 5 of 27 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: three star excellent 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 Care Homes for Adults (18-65 years) Page 6 of 27 How we did our inspection: This is what the inspector did when they were at the care home We met and talked with the people who live in the home. we talked to the manager and staff. We walked round the home to see what it was like. We looked at some care plans and other records. What the care home does well We looked at some care plans and other records. What they do well People say they like living at the home. They say they like the staff. The are enough staff to support them each day People are helped to keep in touch with their families. Care Homes for Adults (18-65 years) Page 7 of 27 What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 8 of 27 If you want to speak to the inspector please contact Geoffrey Senior 33 Greycoat Street London SW1P 2QF 02079792000 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 9 of 27 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 10 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People interested in living at the home may visit and are provided with comprehensive information to help them make a decision about moving in. Assessments are undertaken to ensure that the Home can support the service users needs and aspirations. People can have a trial stay and move in at their own pace. Evidence: The people who live at the home have been there for some time and there have been no recent admissions. Staff explained what happens when people want to come to the home said how important it is that the needs of anyone interested in living there are fully assessed and can be properly supported. Even if they are known to the service people have a long introduction and assessment period where they would be invited to visit the home and join in with some of the things going on or perhaps stay overnight. They could meet and spend time with the people who already live there and the people who support them. They could see what the building and rooms are like and find out about the routine and things that go on at the house. Assessments and reviews that take place help people how best to support people who live at the house.The assessments may also include talking to specialists who can help with the behaviour support plans so that people can be well supported from the start. Service users are Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: helped to say what support they need and how they want it done. Families and other professionals are also invited to have their say. One service user said that she likes living at the home because the staff are about to help if you need it but dont fuss. Written information is available to help people with their choices and the service user guide is now printed in widget, easier to read form, as well. Care Homes for Adults (18-65 years) Page 12 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People know that choices will be offered and they will be supported by staff when making decisions. Staff have access to information and guidelines to help them when they are supporting service users. Evidence: Staff talked about the support plans and said that the way support for the service users is described in clear, guided steps helps every one to understand them better and offer a more consistent approach. Staff are working closely with the service users to find out who and what is important to them and recording how they liked to be supported with their care. They are also noting how people show that they are happy or upset if they are not able to say so. Risk assessments are included as part of the support plans. These are written to help keep people safe in what they choose to do rather than being stopped because something may be seen as unsafe. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: We saw that service users are involved in making choices about things that affect their daily lives such as where to go and what to have to eat, as well as helping prepare the food. They also told us about other things they are able to have a say in. The people who live there chose the colours for the redecoration of the communal rooms as well as the bedrooms. Care Homes for Adults (18-65 years) Page 14 of 27 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 . People in the home are supported to lead busy and interesting lives. They are helped to keep in touch with family and other people important to them. They have food that they enjoy and is well balanced. Evidence: People said that they could stay up late or have a lie in if they wanted to and although there are some routines,they are fairly flexible. Staff in the home work closely residents to find out what interests them and what they do or dont like to do. There is a wide range of things to do indoors and in the community, such as;going to the local gym, cinema and shops. Everyone has their own weekly planner set out using pictures and colours preferable to the individual. There has been some success in securing work experience for an individual with a view to rewarding employment and a more independent lifestyle. The registered manager with the support by the staff team has fostered a positive and active atmosphere within the home. everyone is involved in the Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: day to day running of the home, doing household chores as well as involvement in food shopping and meal preparation.The home does not have a cook. Staff and service users sit round the table together to plan the menu. They then shop for and prepare the lunchtime snacks and main meals of the day. Staff help with the choices to make sure every one has a well balanced diet and any special needs are catered for. People are helped to keep in touch with their family and friends. The names of people who are important to them are noted in their support plans. Staff help with taking people to visit or visitors may come to the home if service users want them to.The staff keep in good contact with significant others to update them on progress and changes. Care Homes for Adults (18-65 years) Page 16 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users are treated with respect and their privacy is respected. Medication systems and procedures are adequate for the needs of the home.The health needs and preferences of the people living in the home are supported by the staff. Evidence: Staff have got to know how each person likes to be supported with their personal care and, as mentioned earlier, guidelines have been written in the support plan, so all the staff should doing the same thing. Staff will go with service users to attend GP, dentist or other healthcare appointment as required. The manager told us that she also has access to a specialist to support people with their mental health. She was able to comment on the current health of all the individuals and gave an example of positive progress being made. At the moment no one living in the home looks after their own medication. Someone has been assessed as being able to manage some aspects of their own medication but has said they prefer not to and this has been accepted. Staff receive training in medication administration and also have to satisfy an assessment of their competence. Service users are encouraged to be involved by asking staff for their medication at the right times. One member of staff is responsible for ordering and checking medication.We looked at the medication records and arrangements for storage and Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: saw that they were satisfactory. All of the service users require assistance or encouragement with some aspects of their personal hygiene and care. The manager makes sure that staff know how to provide this thoughtfully and sensitively. People can wear their own choice of clothes and are generally helped to live their lives as independently as possible. Care Homes for Adults (18-65 years) Page 18 of 27 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 . If people have concerns about their care or safety they, or people supporting them, know what steps to take and who to go to. Evidence: Staff spoken with were clearly aware of their responsibility to safeguard service users from the risk of harm. They have attended Protection of Vulnerable Adults, POVA, training and were clear how they would proceed. They would not hesitate to contact the manager, Providers or Local Authority if they felt there was a risk to the people living at the home. Two service users said that they knew what to do if they were worried about anything and would tell the staff or the manager. Staff said that they knew what signs to look out for if a service user who is not able to speak out was in any way distressed. The organisation makes sure that anyone coming to work at the home has been thoroughly checked out before they are allowed to start work. Care Homes for Adults (18-65 years) Page 19 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The house is homely, well maintained and comfortable. Evidence: We were shown around the home by one of the people who live there. They were proud and keen to show us their private room which was painted in the colour of their choice and full of personal belongings and ornament. They liked very much living in the house and didnt want to be anywhere else. Everyone living there has their own bedroom. The communal areas are furnished with good quality fixtures and fittings throughout. All of the people who live there have their own favourite seat or area they like to spend time in and there is enough room for everyone to be together or seek a bit of peace and quiet if they want. Everyone helps to keep the home clean and tidy. Nowhere is out of bounds to people but staff explained how they safeguard people by supervising some activities in the kitchen and laundry area. There is an enclosed rear garden which is well used in the good weather. A maintenance team is available for repairs and quick response to problems. The home has its own vehicle available for use. Care Homes for Adults (18-65 years) Page 20 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at the home are supported by a staff team who are safely recruited, receive training and support and know what is expected of them. Evidence: Before people are employed as staff at the home the Registered provider completes a number of checks. This is to confirm their identity, take references and do a police check. We looked at the records of staff and saw that these had been done. We were told that there is a low staff turnover and the home does not need to use agency staff so everyone on duty is familiar to the residents. There is a clear staff rota in place so people know who will be supporting them. The Providers want to make sure that people are supported by skilled and caring professionals. To this end they offer staff introductory training before they work on their own and then encourage them to make use of the training opportunities that are offered. NVQs aim to help people deliver good quality residential care services. 5 out of 6 members of staff hold NVQ 2, 2 of them hold NVQ 3 and 2 are currently working towards the NVQ 3. Additional courses being explored for those who have completed level 3. Staff told us that they are able to attend additional training on specialised subject and discuss their development and training needs during regular supervision sessions.They also have staff meetings to talk about how the home is doing and make plans to improve or change things. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Care Homes for Adults (18-65 years) Page 22 of 27 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 . The home is reliably managed. People are listened to when asked what they think about the home and the service it offers and improvements made as a result. Peoples health and safety is promoted.. Evidence: The manager has worked at the home for 7 years and has a good range of experience and training. She has attained NVQ level 4 and is currently studying for the Registered Managers Award She is also training on a specialised course in Applied Behavioural Analysis. She has, when necessary supported staff at other homes within the group through difficult periods and helped to stabilise the service.She organises her work so that she can spend time supporting service users and staff in their daily activities. She has worked to make sure there is an open and positive atmosphere in the home. Staff, relatives and service usersare asked to speak out and tell the manager how they think the service is doing and what changes could be made.The staff said that there is a good team spirit and morale is high. The handover meetings at the beginning and end of each shift ensure everyone knows what is going on and the service users get consistent and informed support. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Monthly visits are carried out by the Directors to the home to ensure that the standard of care and relevant documentation is maintained and that the premises are in good order. They talk aboutlife in the home with both service users and staff and write a report of their visit. We were told that health and safety checks are undertaken and the welfare of staff and service users in the home is promoted. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes  No  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 25 of 27 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 Description 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 Description 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 26 of 27 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.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 27 of 27 - 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!