Care Home: Church Lane

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What the care home does well A comprehensive assessment of need is carried out on prospective residents prior to admission to the home to ensure that assessed needs can be met. Care plans are person centred and focus on providing support in a manner that is required and preferred by the service user. People have choices regarding their lives and are supported to develop skills to further independence and encouraged where able to take responsibility for day to day household chores and meal planning. The home works hard to develop communication aids that enable residents to be inclusive in the running of the home and making lifestyle choices. What has improved since the last inspection? Since the last inspection the dining room, laundry and some residents bedrooms have been redecorated and garden furniture restored. The home has engaged the services of an Occupational Therapist to advise on where improvements can be made within the garden area for the benefit of residents. There has been a slight improvement in the recruitment of permanent staff and training for staff has been ongoing. Documentation in the home has been reviewed and redesigned to be more meaningful to people who live in the home. What the care home could do better: Residents and staff would benefit from the implementation of the proposed change to the care planning format. Some communal areas of the home would benefit from redecoration on the ground floor. Residents would benefit from the implementation of the report submitted by the Occupational Therapist regards the garden area. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Church Lane 21 Church Lane Bearsted Maidstone Kent ME14 4EF     The quality rating for this care home is:   two star good 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: Paul Stibbons     Date: 2 6 0 2 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. that people have said are important to them: They reflect the things 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. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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: Church Lane 21 Church Lane Bearsted Maidstone Kent ME14 4EF 01622730867 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): CareTech Community Services (No.2) Ltd care home 20 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 20. 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). Date of last inspection Brief description of the care home Church Lane residential setting, providing care and accommodation for up to twenty younger adults who have learning difficulties who may also have physical difficulties. The house is divided into 2 separate homes, one of which has a self contained 2 bedroom flat. This has separate access for people living there, but emergency access through the communal corridors leading out of the house. Each home has all its own Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 20 Brief description of the care home self-contained facilities. Care Tech Community Services Ltd owns the home. Currently, two unregistered managers take responsibility for each separate home within the building and manage them on a day-to-day basis. It currently falls under one CSCI registration, and for the foreseeable future, remain this way unless the organisation chooses to register it differently. The home is located close to the centre of Bearsted Green near Maidstone. Local shops, pubs and a church are within walking distance. There is a main line station approximately a mile away and bus services are nearby. The home has several vehicles for communal use. Twenty-four hour care is provided. Fees for this home range from 851.50 pounds to 1894.29 pounds per week Previous inspection reports can be obtained from the home, as can improvement plans detailing the action the home will take to improve the service. 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: two star good 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 peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection for this service was completed on the 12th March 2008. This unannounced inspection was conducted on the 26th February 2009 over a period of 5 hours. A completed AQAA (Annual Quality Assurance Assessment) was submitted by both units within the home prior to the inspection taking place. Discussions were held with the managers, staff and service users during the visit and a variety of records and documents were examined. A tour of the premises was conducted to assess the environment and facilities available. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: 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 7 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 8 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have sufficient information on which to base an informed decision as to whether the home can meet their needs. A comprehensive assessment of needs is carried out prior to admission to ensure the home can meet prospective residents needs. People living in the home have the security of an individual written contract of terms and conditions attached to the placement. Evidence: The home provides a statement of purpose that is specific to the individual home and the resident group they care for. It clearly sets out the objectives and philosophy of the service supported by a service users guide. Admissions are not made to the home until a full needs assessment has been undertaken. The assessment is conducted professionally and sensitively and involves the individual and their family or representative, where appropriate. Where the assessment has Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: been undertaken through care management arrangements the service insists on receiving a summary of the assessment and a copy of the care plan. Prospective residents are given the opportunity to spend time in the home. New residents are provided with a statement of terms and conditions or a contract. This sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. Care Homes for Adults (18-65 years) Page 10 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 living in the home benefit from having an individual plan of care that reflects their assessed and changing needs. People living in the home are consulted and supported in taking risks as part of an independent lifestyle. People living in the home can be confident that information held about them is handled appropriately and their right to confidentiality is upheld. Evidence: The service involves individuals in the planning of care which affects their lifestyle and quality of life. Staff members understand the importance of residents being supported to take control of their own lives and individuals are encouraged to make their own decisions and choices. The service knows and records the preferred communication style of the individual, Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: and uses proven methods that enable the person to lead a full life that promotes independence and choice. These include communication aides such as photographs, pictures, and objects of reference. Care plans are person centred and are agreed with the individual. Plans are written in plain language, are easy to understand and look at all areas of the individuals life, however, plans are far too bulky to be a useful working document. There is a corporate decision to introduce a different format in the near future that addresses this issue. A key worker system allows staff to work on a one-to-one basis and contribute to the care plan for the individual. Care plans viewed included comprehensive risk assessments that are reviewed regularly. The management of risk is positive in addressing safety issues while aiming for improved outcomes for people. The home ensures that residents are consulted regularly through Talk times, resident meetings and reviews to gather information about their satisfaction with the home. Records kept in the home are securely stored. Care Homes for Adults (18-65 years) Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have a range of opportunities that will meet their social, leisure and educational needs and their own personal development. People living in the home are supported in maintaining appropriate relationships with friends and family. People living in the home enjoy a healthy and varied diet that is of their choosing. Evidence: The service has a strong commitment to enabling residents to develop or maintain their skills, including social, emotional, communication, and independent living skills. Individuals are supported to identify their goals, and work to achieve them. One example seen was a reward system for achieving set targets of appropriate behaviour, when spoken to the resident was enthusiastic and committed to achieving the target. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: People who use the service have the opportunity to develop and maintain important personal and family relationships. The staff team help with communication skills, both within the service and in the community, to enable residents to fully participate in daily living activities. Residents are involved in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. They have been fully involved in the planning of their lifestyle and quality of life. Where appropriate, education and occupational opportunities are encouraged, supported and promoted. More able residents attend college and places of employment and there is a range of in-house activities. Residents can access and enjoy the opportunities available in their local community, such as using public transport, library services, the local pub, and local leisure facilities Where appropriate residents are involved in the domestic routines of the home and take responsibility for their own room, menu planning and cooking meals, making sure that they are able to enjoy the food they prefer and like. Carers are sensitive to the needs of those residents who find it difficult to eat and give assistance with feeding. They are aware of the importance of feeding at the pace of the resident, making them feel comfortable and unhurried. Two residents spoken with commented on how much they enjoyed the food in the home. Care Homes for Adults (18-65 years) Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home receive personal support in the manner they prefer and require and their physical and emotional needs are met. People living in the home are protected by the homes policies and procedures for dealing with medication. Evidence: People receive personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. Personal healthcare needs including specialist health care, nursing and dietary requirements are clearly recorded in each health action plan. They give a comprehensive overview of their health needs and act as an indicator of change in health requirements. Personal support is responsive to the varied and individual needs and preferences. The delivery of personal care is individual and is flexible, consistent, reliable, and person Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: centred. Staff respect privacy and dignity and are sensitive to changing needs. People are supported and helped to be independent and can take responsibility for their personal care needs. Residents have access to healthcare and remedial services. Staff make sure that those who are fit and well enough are encouraged to be independent, have regular appointments and visit local health care services. The health care needs of residents unable to leave the home are managed by visits from local health care services. Residents have the aids and equipment they need and these are well maintained to support them and staff in daily living. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. Regular management checks are recorded to monitor compliance. Training records confirm that an assessment has been carried out to ensure each member of staff is competent to manage medication properly. Care Homes for Adults (18-65 years) Page 16 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. People living in the home can be confident that their views will be listened to and acted on and they are protected from abuse and neglect. Evidence: The service has a complaints procedure that is clearly written and easy to understand. The complaints procedure is supplied to everyone living at the home and is displayed on the notice board within the service. Residents and others involved with the home understand how to make a complaint and are clear about what will happen if a complaint is made. The home keeps a full record of complaints and this includes details of the investigation and any actions taken. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Four staff members spoken with demonstrated a good understanding of safeguarding issues and know when incidents need external input and who to refer the incident to. There is a clear system for staff to report concerns about colleagues and managers. Staff that blow the whistle on bad practice are supported by the service. Training of staff in safeguarding is regularly arranged by the Home. Other training around dealing with physical and verbal aggression is also made available to staff as Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: needed. Care Homes for Adults (18-65 years) Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely, safe and comfortable environment with sufficient personal and communal space to meet their needs. Evidence: The home provides a physical environment that is appropriate to the specific needs of the people who live there and where appropriate provides specialist aids and equipment to meet their needs. Several bedrooms were viewed and personal possessions were seen to be on display, one resident spoken with commented on how happy they were with their room. All the homes fixtures and fittings meet the needs of individuals and can be changed if their needs change. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private. Some communal areas of the home would benefit from redecoration on the ground floor. The bathrooms and toilets are fitted with appropriate aids and adaptations to meet the Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: needs of the people who use the service, and are in sufficient numbers and of good quality. The home is well lit, clean and tidy and smells fresh. The management has a good infection control policy. They seek advice from external specialists, such as NHS infection control staff, and encourage their own staff to work to the homes policy to reduce the risk of infection. There is a large garden area and the home has engaged the services of an Occupational Therapist to identify areas that could be improved. Residents would benefit from the implementation of the report submitted by the Occupational Therapist regards the garden area. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported by a competent and qualified staff team in sufficient numbers to meet their needs. People living in the home are protected by the services robust recruitment procedures for new employees. Residents individual and joint needs are met by an appropriately trained and supervised staff team. Evidence: At the time of the visit there was enough staff on duty to meet the needs of the people using the service, with more staff being available at peak times of activity. The staffing structure is based around delivering outcomes for residents and is not led by staff requirements. Training records indicate that all staff members receive relevant training that is focussed on delivering improved outcomes for residents. The home puts a high level of importance on training and staff members spoken with report that they are supported through training to meet the individual needs of people in a person centred way. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Staff members undertake external qualifications beyond the basic requirements, for example, NVQ qualifications and Learning disability qualifications. Managers encourage and enable this and recognise the benefits of a skilled, trained workforce. There is a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the home recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Records viewed confirm that staff meetings and supervision sessions are regular and that staff found them helpful with a focus on improving outcomes for people using the service. Notes and action points are taken of meetings and sessions. 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. Residents benefit from living in a home that is run by a competent and qualified manager and where their rights and best interests are safeguarded. Residents benefit from living in a home where their views underpin all self-monitoring and development of the home and their health, safety and welfare is promoted and protected. Evidence: The manager has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. They work to continuously improve services and provide an increased quality of life for residents with a strong focus on equality and diversity issues and promoting human rights, especially in the areas of dignity, respect and fairness. There is also a focus on person centred thinking, with residents shaping service delivery. There is a strong ethos of being open and transparent in all areas of running of the home. The AQAA contains clear, relevant information that is supported by a Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: wide range of evidence and lets us know about changes they have made and where they still need to make improvements. It shows clearly how they are going to do this. The data section of the AQAA is accurately and fully completed. The manager promotes equal opportunities, has good people skills and understands the importance of person centred care and effective outcomes for people who use the service. The service has sound policies and procedures, which the manager effectively reviews and updates, in line with current thinking and practice. The home works to a clear health and safety policy and all staff are fully aware of the policy and are trained to put theory into practice. Safeguarding is given high priority and the home provides a range of policies and guidance to underpin good practice. There is also evidence of organisational monitoring by corporate providers. Records are of a good standard and are routinely completed. The parent organisation appropriately supports the manager in the running of the service. The home has access to professional business and financial advice and has all the necessary insurance cover to enable it to fulfil any loss or legal liabilities. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Requirement 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 Requirement 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 1 2 23 23 Some communal areas of the home would benefit from redecoration on the ground floor. Residents would benefit from the implementation of the report submitted by the Occupational Therapist regards the garden area. Some communal areas of the home would benefit from redecoration on the ground floor. Residents would benefit from the implementation of the report submitted by the Occupational Therapist regards the garden area. 3 4 24 24 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). 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