Care Home: Canary House

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What the care home does well The service offers a family orientated lifestyle to the three people who live in the home. The one person spoken with was able to confirm he felt very happy in the home and that he felt part of the family group. Two of the people are now aged over 65 and the provider has looked carefully at their lifestyles and managed them appropriately. Meals are taken with the family and choices are given. The resident spoken with said the food was always nice and that drinks and snacks were always available. People who live in the home are encouraged to maximise their independence and to partake in a life style that meets their aspirations. The provider actively encourages the people who live in the home to partake in daily activities that they like, thus ensuring their happiness and well-being. What has improved since the last inspection? When asked the provider could not identify any improvements since the last inspection and clearly felt they provided a good standard of care. What the care home could do better: The daily notes that are contained in the care plans must be completed daily. The provider must ensure her training certificates remain up to date. CARE HOME ADULTS 18-65 Canary House 41/43 Kingswood Road Gillingham Kent ME7 1DZ Lead Inspector Sue McGrath Unannounced Inspection 29th September 2008 09:30 Canary House DS0000029051.V372611.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 Canary House DS0000029051.V372611.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. Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Canary House Address 41/43 Kingswood Road Gillingham Kent ME7 1DZ 01634 319398 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) tinaman41@hotmail.com Mrs Congetta Mantegna Mr Fabio Mantegna Manager post vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care is restricted to three people with learning disabilities between the age of 30 to 65 years of age, with the exception of one service user whose date of birth is 22 May 1925. 20th November 2006 Date of last inspection Brief Description of the Service: Canary House caters for three service users with learning disabilities, who live as part of an extended family. It is in a residential area of Gillingham and is two houses made into one. Close to the main line station and bus services the Home can be easily reached by public transport. The town centre is within walking distance, and has a good selection of stores. The area also has a number of amenities such as a local leisure centre and the historic dockyard at Chatham. Fee range is currently between £335.03 and £405.60. Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a Key Unannounced inspection that took place in accordance with the Inspecting for Better Lives (IBL) process. Key inspections are aimed at making sure that the individual services are meeting the standards and that the outcomes are promoting the best interests of the people living in the home. The IBL process for a Key inspection involves a pre-inspection assessment of service information obtained from a variety of sources including an annual selfassessment and surveys. It is now a legal requirement for services to complete and return an Annual Quality Assurance Assessment (AQAA). This assessment is aimed at looking at how services are performing and achieving outcomes for people. Judgements have been made with regards to each outcome area in this report, based on records viewed, observations and verbal responses given by those people who were spoken with. These judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable The Commission for Social Care Inspection (CSCI) to be able to make an informed decision about each outcome area. Further information can be found on the CSCI website with regards to the IBL process including information on KLORA’s and AQAA’s. The site visit to the service was carried out over one day by Sue McGrath, Inspector, who was in the home from approximately 10:00 until 14:30. The main focus of the visit was to review any improvements made since the last visit and the well being of the service users. Time was spent touring the building, talking to people living in the home, talking to the provider and reviewing a selection of assessments, service user plans, medication records and other relevant documents. Prior to the site visit the AQAA had been returned. At all times the provider was helpful and demonstrated a pro-active approach to ensuring that service users were being supported to the best of their abilities and resources. This report contains evidence and judgements made from observation, conversation and records. Overall this was a positive inspection with good outcomes for service users. The inspector on leaving the home was satisfied that residents were both safe and well cared for and wishes to thank the provider her honesty and hospitality. Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 6 The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. What the service does well: 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. Canary House DS0000029051.V372611.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 Canary House DS0000029051.V372611.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have sufficient information about the home in order to make an informed decision about whether the service is right for them. The personalised needs assessment means peoples diverse needs are identified and planned before they move to the home and they have a contract, which clearly tells them about the service they will receive. Individuals can be confident the home can meet their needs. EVIDENCE: The home had a written statement of purpose and a service user guide. The statement of purpose needed to be updated and this was discussed with the provider. The necessary changes were only minor. The home had three residents who had lived at the home for several years and enjoyed a relaxed and comfortable lifestyle. Two of the residents were over the age of 65 but continue to live life to the best of their abilities and remain Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 9 active. Evidence was seen that the aspirations of the individuals were well met. The aim of the home was to ensure all of the resident’s felt they belonged as part of an extended family. The provider stated that currently the home was full but she was able to discuss fully the procedure that would normally be used for assessing the individual needs of any prospective resident. The actual admission procedure was also discussed and clearly gave prospective residents the opportunity to visit the home to ensure they liked it. The admission process would not normally be rushed to give the residents time to make their minds up about staying. The home would endeavour to work closely with Care Management and any family members. The provider also confirmed the residents were provided with an individual written contract or statement of terms and conditions with the home. Canary House DS0000029051.V372611.R01.S.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in the home can be confident that their individual needs and choices are well supported by the home’s care planning documentation. People who live in the home can be confident that they will be consulted and participate fully in all aspects of life inside and outside the home and will be supported to take risks as part of their independent lifestyle. People who live in the home benefit from information about them being handled appropriately and their right to privacy is maintained. EVIDENCE: All three residents had individualised care plans that reflected their needs. One resident confirmed he had been consulted in drawing up and reviewing his care Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 11 plan and all plans had been signed by the individual resident. It was also confirmed by the provider that regular care management reviews take place. Care plans were normally rewritten every six months, which is regarded as good practise. It was noted that the daily notes had not been written for about two weeks. Daily notes are a good source of evidence to show that care is being provided as detailed in the care plan and they can also help the provider and other interested professionals to audit the care being provided. It is in the homes best interests to be able to show what they have done, along with providing the evidence on which to base the monthly review and to record that they are following the assessed needs. The provider agreed to be more vigilant in maintaining these required documents. The one resident spoken with confirmed he was asked about what he wanted to do and how he wanted to spend his time. He confirmed he was extremely happy living in the home and felt part of the family. Risk assessments were seen for individual residents and these had been mainly reviewed. They had been written to ensure the resident could lead a near normal life with out any unnecessary restrictions. There was no risk assessment that restricted resident’s liberty. Canary House DS0000029051.V372611.R01.S.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home have the opportunity for personal development and are given ample opportunities to maintain and develop independent living skills. The home facilitates meaningful and appropriate leisure activities, which enable the people who live in the home to enjoy a varied and full lifestyle. Links with the community are encouraged which support and enrich an individuals social opportunities. EVIDENCE: All of the residents led different and varied lifestyles. They were encouraged to remain as independent as possible and to maintain and manage their own level Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 13 of personal development. Some of the residents were more active with others requiring slightly more supervision at times. The resident’s privacy and dignity was promoted at all times. Activities were all arranged on an individual basis and were fully led by the residents. For example one resident goes to Rochester Adult Education centre twice a week and chooses what course he follows. Others go to different day centres according to need and their choice. One of the residents also volunteers at a local Oxfam shop on a weekly basis and travels there by local public transport. Leisure activities are also personalised with a variety of arranged activities undertaken. One resident liked to occasionally visit a local social club and another attended Rochester Cathedral for services on a weekly basis. Residents are encouraged to maintain friendships and were possible family relationships outside of the home. One resident confirmed he felt very much part of the family and enjoyed living at the home. The residents went with the providers for a family holiday to relatives abroad and the provider was hopeful they would return later on in the year for a family party. The resident spoken with confirmed routines were flexible depending on what they chose to do for the day. Residents were encouraged to make choices about daily living routines and evidence was seen that regular meetings take place that influence the policies of the home. Residents were encouraged to help around the home, which some enjoyed more that others. One resident was particularly helpful around the home and enjoyed sweeping the front and rear gardens. The residents would normally eat with the family and the provider confirmed they were given choice over their meals. The provider also stated that a written menu was not available as she felt this was more homely. The resident who was at home confirmed the food was always very nice and that there was always plenty to eat and drink at all times. Normally the residents would prepare their own breakfast in their own kitchen area. Snacks would also be available there during the day. Sometimes the residents go out for meals with either friends or the family. Canary House DS0000029051.V372611.R01.S.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home benefit from receiving personal care in private and enjoy a very flexible lifestyle. Health needs are met and the people who live in the home benefit from having full access to all professional health care services as required EVIDENCE: The provider clearly understands the key principles of giving personal support and was responsive to the varied and individual requirements of the residents in their care. Attention was given to ensuring the individuals privacy and dignity was maintained during personal care and it was clear that the provider was sensitive to the individuals changing needs. The personal and health needs of residents were well met with evidence of good multi disciplinary working taking place on a regular basis. The home promoted and maintained residents health by facilitating and supporting Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 15 residents with medical appointments as necessary. This included visits to Opticians, Chiropodists and other health professionals as needed. All residents were registered with a GP of their choice. The administration of medication was reviewed and was found to be adequate. The provider was advised to obtain a copy of the Royal Pharmaceutical Society of Great Britain guidance to ‘the Safe Handling of Medicines in Social Care’, to ensure full compliance. This can be obtained from www.rpsgb.org.uk Mar sheets were viewed and were found not to have been completed over the weekend. The provider was aware of the issue and agreed it was not good practise. The provider did attend a one-day training on the safe administration of medication and discussion took place regarding a more in depth courses that are available. Canary House DS0000029051.V372611.R01.S.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home are protected from potential abuse and have access to a clear complaints procedure which they fully understand and know how to use. They further benefit from having their views and concerns listened to and acted upon without delay. EVIDENCE: The home had a clear complaints procedure that meets the demands of regulation. The provider confirmed they listened to the residents and dealt with any minor issues before they had the chance to escalate into any formal complaints. The Home had received no complaints since the last inspection and thus has no written records or records of outcomes of complaints and concerns. The Commission has not received any complaints about the service, The provider had a good understanding of the protection of vulnerable adults process and whistle blowing procedures. The home had adopted the revised Kent and Medway Adult Protection Policy. Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a safe, well maintained and homely environment in which good standards of décor are maintained. EVIDENCE: The home was well maintained throughout and the lounge areas were homely and comfortable. The décor and all lighting and soft furnishings were domestic and it was evident the residents liked the environment. One bedroom was viewed and was found to be personalised and comfortable. The other bedrooms were not viewed, as the residents were either out or not available. The home had two kitchen areas, which were clean and tidy. The home had sufficient bathrooms and toilets for the residents to use. Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 18 There was a games room in the cellar but the provider said the residents no longer used this area as they now had other interests. Evidence was seen that the home had the required fire alarms and the provider confirmed these were well maintained and regularly checked. Some of the residents enjoyed helping around the house and in the garden. Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is This judgement has been made using available evidence including a visit to this service. The home does not employ any staff so these standards are not applicable. EVIDENCE: Canary House DS0000029051.V372611.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home benefit from living in a home where the manager is competent, enthusiastic and experienced. EVIDENCE: The provider had completed a Registered Managers Award (RMA) and was able to demonstrate that she had the experience and knowledge to ensure the best and most appropriate support and care for the people in her care. The atmosphere in the home was very much family orientated and was relaxed and friendly. Canary House DS0000029051.V372611.R01.S.doc Version 5.2 Page 21 Although the manager had completed some training recently there were still some gaps where certificates had not been updated. Discussion also took place regarding the level of first aid training that had been undertaken and advise was given to ensure the home meets with the Health and Safety Executives recommendations. Regular meetings with the residents ensured they were given the opportunity to make choices and that they had a say in what happens in the home in conjunction with the other family members. The hard wiring certificate, which was mentioned in the last report, was produced but the provider could not confirm that work identified had been completed. The certificate was due for renewal in November this year. The following day the provider contacted the inspector and assured her that an electrician had been booked to complete another survey and that any identified work would be carried out. The water temperatures in the baths and the sinks were not monitored and Thermostatic Mixer Valves had not been fitted. Again the following day the provider confirmed these valves had been ordered and would be fitted as soon as possible. Standard 42.3v states that there should be a provision of window restrictors to upper floor windows, based on assessment of vulnerability of and risk to service users. The providers are strongly advised to complete such a risk assessment and act upon the outcome. The AQAA confirmed that the home had an appropriated fire detection system in place and that it was well maintained. Canary House DS0000029051.V372611.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 2 3 4 5 CONCERNS AND COMPLAINTS Standard No Score 22 23 3 3 X 3 3 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000029051.V372611.R01.S.doc LIFESTYLES Standard No Score 11 3 12 4 13 3 14 3 15 3 16 4 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Canary House Score 3 3 2 X 4 4 3 X X 2 X 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. 1 Standard YA6 Regulation 15 Timescale for action The registered person shall, after 31/10/08 consultation with the service users or their representative, prepare a written plan as to how the service users needs in respect of this health and welfare are to be met. Daily records must be maintained on a daily basis. Requirement 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. Refer to Standard YA42 Good Practice Recommendations It is recommended that the provider ensure all of her training certificates are up to date, current and relevant to the needs of the people who live in the home. Canary House DS0000029051.V372611.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 Canary House DS0000029051.V372611.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. 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