Care Home: 6 Beacon Road

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What the care home does well The home has a mainly established staff group who are aware of residents needs. An observation of communication between the staff and the resident in the home at the time was friendly, knowledgeable and calm. One member of staff said that they tried to be proactive rather than reactive to known challenging behaviours.The Registered Manager resigned last year. A person to take responsibility for the day to day management of the home has now been appointed and is currently applying for registration. The home has involved residents in the running of the home by involving them in staff recruitment and the manager described plans to involve a resident representative in dealing with any concerns should they arise. A member of staff informed the Inspector of a possible behavioural situation and how best to deal with it. This was done in a discrete and clear manner. Diversity is promoted and staff supports the different religious and cultural needs of residents through enabling attendance at religious services and by cooking specialised food. Some maintenance is to be undertaken, however this had been recognised and was planned for. What has improved since the last inspection? The service has met the requirements made from the previous inspection. Redecoration has been undertaken in different areas of the home and plans for the coming year include redecorating and re-planning the office layout and improve the garden. The newly appointed manager has robust plans for regularly reviewing staff competency. Quality assurance has been well documented and a clear report has been written including areas for change as well as plans for improvement. What the care home could do better: No requirements or recommendations were made. CARE HOME ADULTS 18-65 6 Beacon Road Herne Bay Kent CT6 6DH Lead Inspector Wendy Gabriel Unannounced Inspection 8th July 2008 10:00 am 6 Beacon Road Doc2.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 6 Beacon Road Doc2.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. 6 Beacon Road Doc2.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 6 Beacon Road Address Herne Bay Kent CT6 6DH 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) 01227 363137 maggie.woods@btconnect.com Dyzack Limited Manager post vacant Care Home 4 Category(ies) of Learning disability (0) registration, with number of places 6 Beacon Road Doc2.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Learning disability (LD). The maximum number of service users to be accommodated is 4. Date of last inspection 8th August 2006 Brief Description of the Service: The home is an ordinary semi-detached house and is located in a quiet residential street within normal walking distance of Herne Bay’s town centre. All bedrooms are singe occupancy. To the rear of the building there is an enclosed garden. There is some parking in the road to the front of the home. The Registered Provider is a private company. The managers’ post is vacant but a person has been identified to undertake this role and is currently applying for registration. The fee for this home is in the range of £1400 - £2500 per week. Please contact the provider for further up to date information about fees and services. 6 Beacon Road Doc2.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. Inspection methods used during this visit included looking at documents and records, an accompanied tour of the premises, being introduced briefly to a resident and speaking to two members of staff and the manager. We looked at the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. The Home returned the AQAA when we asked for it. This was clear and comprehensive. It identified areas that have improved in the last year and others where further developments are either planned or would benefit residents. This included evidence that the service seeks the views of residents. There were two members of staff and one resident in the home at the time of the unannounced inspection. The person undertaking to oversee the home was called in from a nearby co-owned home, where the person is the Registered Manager, to participate in the inspection. Two residents were at college and a third resident was on holiday. The registered manager resigned last year. A person to take responsibility for the day to day management of the home has now been appointed and is currently applying for registration. For the purpose of this report they will be referred to as the manager. The service has met all previous requirements. Some maintenance issues were noted but these had been identified by the home and an action plan had been arranged. A broken window frame was made safe during the inspection and the repairer confirmed that a new window had been ordered to replace it. The home has made good progress since the last inspection with involving residents in certain aspects of running the home. What the service does well: The home has a mainly established staff group who are aware of residents needs. An observation of communication between the staff and the resident in the home at the time was friendly, knowledgeable and calm. One member of staff said that they tried to be proactive rather than reactive to known challenging behaviours. 6 Beacon Road Doc2.doc Version 5.2 Page 6 The Registered Manager resigned last year. A person to take responsibility for the day to day management of the home has now been appointed and is currently applying for registration. The home has involved residents in the running of the home by involving them in staff recruitment and the manager described plans to involve a resident representative in dealing with any concerns should they arise. A member of staff informed the Inspector of a possible behavioural situation and how best to deal with it. This was done in a discrete and clear manner. Diversity is promoted and staff supports the different religious and cultural needs of residents through enabling attendance at religious services and by cooking specialised food. Some maintenance is to be undertaken, however this had been recognised and was planned for. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 6 Beacon Road Doc2.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 6 Beacon Road Doc2.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): 1,2,3. Quality in this outcome area is good. Prospective residents are given clear information to make an informed choice about where to live including a statement of terms and conditions about the home. Prospective residents know that their individual needs and choices will be assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said that she and another Registered Manager within the company are working on a new pre assessment document that is to be more person centred. They will use the document ‘Listen to Me’ to enable prospective residents to individually express their needs. The manager said that any vacancy would not be filled unless the prospective resident was able to fit in with the established residents and that the home could offer support and or specialist services to meet assessed needs and preferences. Assessments are also used from the placing agencies of individual residents. Prospective residents have access to the statement of purpose, the service users guide and a contract of terms and conditions of residency to help them 6 Beacon Road Doc2.doc Version 5.2 Page 9 make an informed choice about choosing where to live. These have photos or pictures and are in a clear and easy to understand format that is suitable for the people who use the service. 6 Beacon Road Doc2.doc Version 5.2 Page 10 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): 6,7,8,9,10. Quality in this outcome area is excellent Residents know that their needs and goals are assessed and that they are supported to make decisions and take risks. They are enabled to participate in decisions about the home. Confidential information is held in a secure facility. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home uses individual person centred plans that reflects the needs, aspirations and goals of people. The plans put the individual at the centre of the service delivery. Two plans were looked at and information was crossreferenced with daily records, reviews, risk assessments and health action plans. 6 Beacon Road Doc2.doc Version 5.2 Page 11 Reviews are regularly undertaken with significant family members, social worker, the homes manager, senior carer and the resident. There was good written evidence of regular input by health care professionals. A member of staff confirmed that people who live in the home knew about their plans and that if they could not read they would be informed what was in them. Some of the information was in a format suitable for the residents and simple pictures were used. Behavioural guidelines included communication skills and cultural and religious needs. Risk assessments are clear and regularly reviewed. Regular contact with professional people significantly involved in some decision-making is robustly undertaken. Previous comments from social workers and some families indicated that some challenging behaviours has decreased. The manager said this was because staff were aware of the guidelines and as confirmed earlier by a member of staff, they tried to be proactive towards any challenging behaviour rather than reactive. Observation of staff with a resident confirmed that they recognised that a behaviour pattern was starting and acted suitably and calmly to make the person feel secure and relaxed. The manager said that a resident is involved in interviewing new staff and that one resident had asked if he and the others in the home would be able to help choose a new manager. This was confirmed to the satisfaction of the resident. Although no concerns had been raised, the manager said that they would try to involve a resident by telling them about the issue (without giving names or instances) and ask for their opinion on what they felt should be or have been done. This promotes residents opportunities to have their views heard and acted on. Confidential information is locked in a secure office. 6 Beacon Road Doc2.doc Version 5.2 Page 12 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): 12,13,15,16,17. Quality in this outcome area is excellent. Residents know that they are encouraged to undertake leisure and work opportunities and that appropriate relationships are supported. Residents know their rights are respected. Menus reflect a healthy and culturally varied diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Activity plans are individual for each resident. Three residents attend mainstream or community college. Another has an in house programme of independent living skills and other preferred activities. The home has a vehicle capable of seating all residents. People who live in the home have complex needs and the service understands the importance of residents achieving their goals. There was written evidence 6 Beacon Road Doc2.doc Version 5.2 Page 13 from a professional party and verbal evidence from the manager regarding one person visiting his relative and how this had been achieved. Families are welcome and community based friendships and activities are encouraged. The home has a separate office in the town and the staff are arranging for one person to be involved in work related activities there. Holidays are taken individually and according to needs and preferences. One person was on holiday with his family and was due to return on the day of the inspection. Another had been to Egypt. The menu was balanced and culturally varied and appropriate food can be prepared by a member of staff with knowledge of same. There were fresh vegetables and fruit in the home and green vegetables were seen being prepared for lunch. The kitchen is light and spacious and was clean and well organised. 6 Beacon Road Doc2.doc Version 5.2 Page 14 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. Quality in this outcome area is good Residents know that physical and emotional support will meet their assessed needs. Residents are protected by medication administration procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two requirements made at the previous inspection have been met. The home does not hold excess medication and the storage was clean and items stored were in date. Storage is in a dedicated and suitable metal cupboard. Administration records were signed appropriately. All staff have undertaken medication administration training, this was stated by both members of staff and the manager. Staff files were not available as they are held in another office therefore training certificates were not seen. 6 Beacon Road Doc2.doc Version 5.2 Page 15 There was good written evidence of input by health care professionals and that personal and health needs are being met. The staff group is a balance of male and female for delivering care. The home works closely with specialists for advice and support and records confirm this. 6 Beacon Road Doc2.doc Version 5.2 Page 16 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. Quality in this outcome area is good. Residents know their views are listened to and acted upon and that they are protected from abuse, neglect and self-harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No complaints have been received since the previous inspection. The home maintains a complaints policy and procedures. There is information on how to make a complaint that is in a suitable format for residents. The manager said that she is planning for residents to be involved should a complaint or concern be received. The resident would not be informed of names or specific details but would be asked to comment on the issue raised and ask for their opinion on what they felt should be or have been done. This is good practice as it allows residents to feel included in the running of the home and offers a culture where residents can feel safe to express their opinions. Staff receives training on adult protection and a member of staff was very clear in what to do if abuse was suspected. The manager also knew procedures regarding reporting adult abuse. 6 Beacon Road Doc2.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): 24,30. Quality in this outcome area is good. The home is safe, clean and homely and identified maintenance issues will improve the environment. Bedrooms are individual and lockable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was clean and tidy and the décor and furnishings modern in character to suit the age range of the residents. Bedrooms are individual and have locks. Residents who were out of the home at that time locked their bedrooms and the staff respected this by not overriding this during the ‘tour’ of the premises. The heating was on and the manager was to check on the reasons for this on a hot day. A bedroom window frame was broken away from the glass and the 6 Beacon Road Doc2.doc Version 5.2 Page 18 manager immediately sought assistance for this to be made safe. It was confirmed that this had been reported that morning when it first happened and a new window ordered. It was made safe within the half hour. Some general maintenance is planned for including edging to the laminate floor in one bedroom and replacing missing spindles to the banister. Also a banister on the top floor is to be made more secure. The garden shed is to have the roof repaired as it is sagging. These items will improve the health and safety of the people who live in the home. Decoration has been undertaken in the past year in much of the home and this will continue this year with the office and improvements to the garden. 6 Beacon Road Doc2.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. Quality in this outcome area is good. Residents benefit from competent, well trained staff. Recruitment checks protect residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff undertake the mandatory training and most have undertaken NVQ 2 or 3. The communication between two members of staff and a resident was honest and calm and met that persons assessed needs. No staff files are kept in the home therefore records of recruitment or training certificates were not seen. However, information from the previous inspection states that recruitment procedures are robust. The AQAA states that staff training has been developed to follow the Learning Disability Awards Qualification (LDAQ) over the year. The manager said that induction is also in line with LDAQ. Staff confirmed the training and that some courses are soon to be updated. 6 Beacon Road Doc2.doc Version 5.2 Page 20 Previous comments by relatives said that there was always enough staff on duty and a care manager has said previously that there was always someone to speak to. A new member of staff is being recruited. 6 Beacon Road Doc2.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): 37,39,42. Quality in this outcome area is good. The home is well run. Residents know their health and safety will be protected. Residents know their views are considered in the running of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is currently applying for registration. The home has developed residents input into the running of the service through representation at staff interviews and involvement with complaints should any arise. 6 Beacon Road Doc2.doc Version 5.2 Page 22 The home has improved the care plans and risk assessments over the past year to be person centred. An annual quality assurance statement was seen that identified areas for improvement including residents involvement in the future running of the home. Questionnaires are sent out to families around Christmas and these are collated and used as a basis for the quality assurance report. Maintenance checks and fire safety records were in date. 6 Beacon Road Doc2.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 3 2 4 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 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 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 4 3 3 LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 6 Beacon Road Doc2.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 6 Beacon Road Doc2.doc Version 5.2 Page 25 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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