Care Home: 68 Milton Road (Welcome House)

Similar services:

• 1 Marten Road
• Daubeney House
• Three Gables
• Aldwick House
• 49 Glendale
• The Springs Community
• Crossways Community
• Belle Vue Country House

What the care home does well 68 Milton Road is one of three small homes situated close together providing semi-independent living for up to three people who have or have had mental health problems. There is a small staff team that is available from 9-5pm during the week and for 2-4 hours at the weekends to provide support and assistance. The environment is homely and comfortable and residents are responsible for the up keep and general cleanliness of the house with staff assistance. The manager maintains all records that were examined in an organised manner. Records relating to service users were well maintained and informative. Health and safety issues are addressed through safe working practices, suitable training and necessary maintenance. Service users are encouraged to take responsibility for all aspects of their daily living from preparing snacks to arranging appointments and managing finances. Staff do provide a cooked meal once a day however. What has improved since the last inspection? A new manager has been appointed who has spent time to get acquainted with the service and has made some improvements surrounding individual service user plans and supporting people to develop greater levels of independence in a planned way. CARE HOME ADULTS 18-65 68 Milton Road (Welcome House) 68 Milton Road Gillingham Kent ME1 3AE Lead Inspector Joseph Harris Unannounced Inspection 26th June 2008 10:30 68 Milton Road (Welcome House) DS0000028991.V365838.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 68 Milton Road (Welcome House) DS0000028991.V365838.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. 68 Milton Road (Welcome House) DS0000028991.V365838.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 68 Milton Road (Welcome House) Address 68 Milton Road Gillingham Kent ME1 3AE 01634 574644 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) amanda@welcomehouse.co.uk Dr Toqeer Aslam Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places 68 Milton Road (Welcome House) DS0000028991.V365838.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2006 Brief Description of the Service: 68 Milton Road is a registered care home for three adults with mental health problems. It is one of nine homes owned and managed by the Welcome House Group. At present two service users live at the home. They are supported by a small team of staff consisting of a manager and a support worker. The service user guide, statement of purpose, and reports from the Commission for Social Care inspection are available to service users and are kept in the lounge. Weekly fees are £580. Purchasers of the service will be given a full breakdown of the fees charged. Staff are not on duty in the evening or overnight. During these times service users have access to an on-call staff member. The home is situated in a residential area with easy access to public transport and local shops. Gillingham town centre is approximately one mile away. 68 Milton Road (Welcome House) DS0000028991.V365838.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 key unannounced inspection process culminated in a site visit to the home on 26th June 2008. The site visit commenced at approximately 10.30am and concluded at 1.30pm, lasting for around 3 hours. During the course of the visit a tour of the premises was undertaken and discussions were held with the acting manager, staff members and service users. A range of documentation was examined relating to the residents, staff, medication, health and safety and the day-to-day running of the home. The home also returned the Annual Quality Assurance Assessment (AQAA), which provides information to inform the inspection process. What the service does well: What has improved since the last inspection? A new manager has been appointed who has spent time to get acquainted with the service and has made some improvements surrounding individual service 68 Milton Road (Welcome House) DS0000028991.V365838.R01.S.doc Version 5.2 Page 6 user plans and supporting people to develop greater levels of independence in a planned way. 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. 68 Milton Road (Welcome House) DS0000028991.V365838.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 68 Milton Road (Welcome House) DS0000028991.V365838.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. Quality in this outcome area is good. The needs and aspirations of service users are assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One service user’s file was viewed. This contained appropriate information gathered prior to the resident moving into the home. The majority of prospective residents are referred from other homes within the organisation as a step towards greater independence. The organisation has developed a referral form that is completed following receipt of recent Care Programme Approach (CPA) documents and background history. The manager follows the standard assessment procedure and spends time with the prospective resident during visits to the service. Information is received from an individual’s care manager and the service user and significant others are also consulted with as appropriate as part of the assessment process. 68 Milton Road (Welcome House) DS0000028991.V365838.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. Quality in this outcome area is good. The needs and risks for service users are reflected in individual plans of care. People who use the service are able to make decisions affecting their daily lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One service user’s file was examined demonstrating individual plans of care are developed for each resident. The support plans are based on the assessed needs, information from healthcare professionals and the aspirations of each service user. All relevant aspects of care and support are covered within the plan and suitable guidance is provided to enable staff to meet needs consistently. The plans are regularly reviewed and updated as needs change. Service users are encouraged to be involved in the planning process and sign the completed plans. 68 Milton Road (Welcome House) DS0000028991.V365838.R01.S.doc Version 5.2 Page 10 The aim of the home is to provide support for residents to live as independently as possible. People who use the service are assisted and encouraged to make decisions affecting all aspects of their daily lives. Residents manage their own finances, medication and are responsible for organising their own time, unless otherwise assessed. Risks are suitably assessed through a risk management process. Residents are encouraged and supported to take responsible risks and are an integral part of the assessment process. The risk management plans provide adequate detail to enable staff to minimise perceived risks and encourage independence. 68 Milton Road (Welcome House) DS0000028991.V365838.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, 17. Quality in this outcome area is good. Service users have a lifestyle that meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are supported to be as independent as possible and are responsible for organising their own activities and time. Staff are available during office hours to provide support. Regular 1:1 sessions are held with residents to discuss future plans, activities and any other health or social issues. Service users confirmed that they have receive assistance support from the staff as and when they require. Residents stated that they like the atmosphere in the home and that they receive the support they need. There is a parade of local shops nearby and the town centre is a manageable walk from the home. There is a good public transport nearby. Residents said that they access local facilities on a regular basis. 68 Milton Road (Welcome House) DS0000028991.V365838.R01.S.doc Version 5.2 Page 12 Visitors are welcome to the visit the home at any reasonable times. It was not possible to speak to any visitors during the site visit. Service users are provided with one main meal per day, which is cooked by staff. Residents are responsible for all other meals and shopping. It was reported that staff do work with individual residents to help plan, prepare and cook meals where required or as part of a rehabilitation programme. A record of food cooked for service users is maintained. 68 Milton Road (Welcome House) DS0000028991.V365838.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. Quality in this outcome area is good. Residents receive support with their personal and healthcare needs appropriately. Medication systems are well managed and residents are supported to selfmedicate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are responsible for managing their own personal and healthcare needs with support as needed. In discussion people that use the service said that staff provide support and assistance when required. Any aspects of personal care that require support are suitably addressed in the individual plans of care. Service users are responsible for keeping their medical and healthcare appointments, but staff are available to provide support if required. Records relating the healthcare needs of service users are well maintained and include the nature of the visit, outcomes and actions. All service users are registered 68 Milton Road (Welcome House) DS0000028991.V365838.R01.S.doc Version 5.2 Page 14 with local General Practitioners and it was reported that the home receives very good support from the local community mental health services. Residents are encouraged to organise any visits to dentists, opticians and other complimentary health practitioners. Service users are at differing stages of self-medicating programmes and competency and understanding are assessed on a periodic basis. Issues such as knowledge of medications and history of compliance are taken into consideration within this process. The home is advised to further develop their self-administration assessment process to include ‘open-ended’ questions and provide a structure demonstrating the steps towards full self-medication. Refer to recommendation 1. 68 Milton Road (Welcome House) DS0000028991.V365838.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. Quality in this outcome area is good. Service user’s views are listened to and acted upon. Residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a clear and well-established complaints procedure in place, which service users stated that they were aware of. One resident stated that they have had no complaints, but would raise any issues with staff or senior managers who visit the home. There have been no complaints since the last inspection. The organisation has developed clear policies and procedures relating to adult protection issues and abuse awareness. These cover the signs and nature of abusive practice and actions to take following a disclosure. Staff have received appropriate training through the induction programme and additional training covering this topic. Discussions were held with the manager, staff and service users regarding their knowledge of information available in the home. There have been no adult protection concerns since the last inspection. 68 Milton Road (Welcome House) DS0000028991.V365838.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. Quality in this outcome area is good. The home is suitable for the needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 68 Milton Road is situated on a residential road on the outskirts of Gillingham. There is one main lounge and a kitchen, which are both domestic in size. There is an enclosed garden to the rear of the property. There are toilets and bathrooms on both floors and residents all have separate bedrooms. Both residents spoken to said that they like the house and it comfortably meets their needs. The house is in a good state of repair and is homely, comfortable and hygienic. Residents take the main responsibility for the household chores with support from staff as needed. The laundry facilities are sited in the kitchen and staff and service users follow domestic guidance to promote infection control. 68 Milton Road (Welcome House) DS0000028991.V365838.R01.S.doc Version 5.2 Page 17 It was reported that the home meets the requirements of the environmental health and fire departments. 68 Milton Road (Welcome House) DS0000028991.V365838.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 and 35. Quality in this outcome area is good. Service users are supported by competent and well-trained staff. Suitable recruitment practices are followed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are two staff members employed at the home who have both achieved National Vocational Qualifications (NVQ) in care at level 2 or above and demonstrated a good understanding of the needs of the service and residents. The organisation operates a thorough recruitment process ensuring that all required checks are completed and records obtained prior to appointment. 1 staff file was examined providing evidence of all required employment checks and information including CRB checks, two written references and proof of identity among other records. Staff complete required mandatory training within the first 6 months of employment and work through an induction programme covering all key aspects of the service including the Skills for Care Common Induction Standards. Staff currently receive in-house fire training and the organisation 68 Milton Road (Welcome House) DS0000028991.V365838.R01.S.doc Version 5.2 Page 19 should provide periodic training from a certified fire trainer to ensure that current practice is accurately reflected. Refer to recommendation 2. 68 Milton Road (Welcome House) DS0000028991.V365838.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. Quality in this outcome area is good. The home is well run, in the best interests on the service users. Health, safety and welfare issues are suitably managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been in post for approximately 6 months and is yet to be registered with the Commission for Social Care Inspection. Refer to recommendation 3. She has had over 9 years of experience working in community care settings at various levels of responsibility. She is due to commence her Registered Manager’s Award in the coming months and already has NVQ levels 2 and 3 in care. 68 Milton Road (Welcome House) DS0000028991.V365838.R01.S.doc Version 5.2 Page 21 The organisation has a quality monitoring and assurance structure, which includes regular monthly monitoring visits and satisfaction questionnaires. Service users stated that they feel their opinions of the home are taken into account and said that they talk to senior managers as part of the quality assurance programme. All health and safety information is maintained and up to date with service certificates and fire safety records in place. Accidents and incidents are recorded and reported appropriately. There are policies and procedures in place addressing safe working practices. 68 Milton Road (Welcome House) DS0000028991.V365838.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 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 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 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 68 Milton Road (Welcome House) DS0000028991.V365838.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. 1. 2. 3. Refer to Standard YA20 YA35 YA37 Good Practice Recommendations To develop self-medication assessments based on measurable outcomes. To provide periodic fire training from a qualified trainer for all staff and, where possible, service users. The manager should apply for registration with the Commission for Social Care Inspection. 68 Milton Road (Welcome House) DS0000028991.V365838.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. Extracts may not be used or reproduced without the express permission of CSCI 68 Milton Road (Welcome House) DS0000028991.V365838.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!