Care Home: Eastry Villas

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What the care home does well There was recorded evidence of health and psychological care being recognised and attended to. Many outside agencies are included in the welfare of people in the home including occupational therapist, psychiatrist, speech and language, agencies for the blind and other health care professionals. Staff have responded well to the needs of different people including supporting one person with sight and hearing loss to walk in the village with confidence. Staff training is robust and staff spoke of how good the company is in providing training. `Brilliant` and `unbelievably good` were said about the amount of training given. There was evidence of training certificates on display in offices. What has improved since the last inspection? Senior staff have all received the appointed person training in first aid. This had been a recommendation at the last inspection. What the care home could do better: The proposed building works has meant that refurbishment and repair has not been ongoing recently. But work must be undertaken in several areas for health and safety despite building work starting in the near future. Some doors and drawer fronts are missing in Mill House kitchen and it is in need of an overhaul. The cupboards and drawers should be covered, as the contents get dirty through general usage of the kitchen. A recommendation is made for suitable coverings for this area to be put in place. The staff have to work very hard indeed to maintain cleanliness in this area and the kitchen was clean and tidy on the day of the unannounced inspection. A bathroom has a box covering for pipes that has become loose and could be a hazard to health and safety. The team leader agreed to get this done immediately. A requirement is made for risk assessments to be reviewed for those windows without restrictors as some seen on the day opened fully and could be a hazard for some people. The staff sleep in room in Forge House is on the lower ground floor and has only one exit, a requirement is made for this to be risk assessed for fire safety. A recommendation made at the previous inspection for more user-friendly care plans has not yet been achieved. CARE HOME ADULTS 18-65 Eastry Villas High Street Eastry Sandwich Kent CT13 0HE Lead Inspector Wendy Gabriel Key Unannounced Inspection 28th January 2008 09:30 Eastry Villas DS0000048300.V358702.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 Eastry Villas DS0000048300.V358702.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. Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastry Villas Address High Street Eastry Sandwich Kent CT13 0HE 01304 611600 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) Family Care Homes Ltd Miss Rosemary Chapman Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2007 Brief Description of the Service: Eastry Villas is the collective name for three small units on or adjacent to the Eastry House grounds, owned by Family Cares Homes Ltd. The units are individually known as Mill House, Gore House and Forge house and are incorporated into one registration to be known jointly as Eastry Villas. Forge house is a small semi detached period property adjacent to the car park of Eastry House. Gore House is a detached house. Mill House is also a detached house. Gore House and Mill House will be attached to each other when building has been completed. There is limited parking on the Eastry House site but there is a car park near by in the village. Service users of all three units have their own gardens but also have access to a purpose built day centre on the Eastry site. Information on the home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The provider web address is fchltd.headoffice@virgin.net Fees are in the range of £591.11 - £2215.40. For further details please contact the provider. Eastry Villas DS0000048300.V358702.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 that the people who use this service experience good quality outcomes. The Registered Manager was on annual leave at the time of the unannounced inspection. The senior staff in each of the three houses making up Eastry Villas and the team leader were helpful in providing information about the way the home works. All the people living in the villas were introduced and one person warmly greeted the inspector on arrival in the front drive. Proposed building works are due to take place in the very near future. It is understood that no redecoration or refurbishment has taken place because of the complete restructuring of the houses. However there are some areas that must have some attention for health and safety purposes. Staff have worked very hard indeed to keep the premises clean and tidy despite parts of the buildings being in need of refurbishment and repair. People were friendly and busy with different activities and the rapport with staff was appropriate and homely. The inspector read some records, policies and procedures and compared these to day reports and other records. The Inspector spoke to some people who live in Eastry Villas, some staff and the team leader. Comment cards were left for people living in the home, staff, families and Health care professionals. An accompanied tour of all three houses comprising Eastry villas was undertaken. What the service does well: There was recorded evidence of health and psychological care being recognised and attended to. Many outside agencies are included in the welfare of people in the home including occupational therapist, psychiatrist, speech and language, agencies for the blind and other health care professionals. Staff have responded well to the needs of different people including supporting one person with sight and hearing loss to walk in the village with confidence. Staff training is robust and staff spoke of how good the company is in providing training. ‘Brilliant’ and ‘unbelievably good’ were said about the amount of training given. There was evidence of training certificates on display in offices. Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 6 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 Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 8 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 Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 9 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. Prospective residents know their needs and aspirations will be met and that they are given information to make an informed choice about where to live. EVIDENCE: The manager of the client care dept and the team leader visits prospective residents in their own home. A full written assessment is made and used to make a decision about meeting the needs of the individual. Eastry Villas provides a statement of purpose and service users guide for prospective residents to be able to make an informed choice about where to live. Eastry Villas DS0000048300.V358702.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. Residents know their individual needs and personal goals are recorded and are involved where able with their own plans. Individual risk assessments protect residents from harm. Confidential information is secure. EVIDENCE: All three houses in Eastry Villas have care plans that record a wide variety of information about peoples’ individual needs and aspirations. These, as recorded in the previous inspection report, show little evidence of involvement by the individuals. A recommendation is made for these to be reviewed into more person centred plans. The team leader discussed this and staff were also keen to work towards person centred planning and were able to understand the real benefits for individuals. Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 11 The team leader has devised a very useful ‘grab’ file for each person and these contain up to date information for quick reference and are user-friendly and are more person centred. Health action plans have also been developed and these are up to date and a good and clear reference for staff. Reviews were being undertaken for all care plans. Risk assessments have identified a wide range of areas for individuals and the team leader agreed to review information to include more detailed information for staff actions. Meetings take place in all three properties in Eastry Villas and some are now based on 1 –1 between the individual living in the home and their key worker. This then may be followed up with another meeting that includes the team leader. Communication in all three houses was noted to be clearly based on peoples’ choices. Although some communication was limited, people were observed letting staff know about their choices. Confidential information is kept in secure environments in all three properties in Eastry Villas. Eastry Villas DS0000048300.V358702.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 know that they can take part in age, peer and culturally appropriate activities in the home and community. People know their families are welcomed and that friendships are enabled. Menus are varied and may cater for dietary needs. EVIDENCE: There is a purpose built day centre on the site of Eastry Villas and people have the opportunity of attending one or more times a week. The centre offers a variety of activities including craft, jewellery making, woodwork, literacy, telling the time, numeracy, beauty, foot spa, aromatherapy massage, maketon, needlecraft, cookery, and puzzles and music and dancing. Church services are held in the day centre monthly and people are encouraged to attend services in the church in the village. Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 13 Outings are undertaken and all three properties in Eastry Villas have their own vehicle. Horse and carriage riding is available during the warmer months and some people enter shows and have won rosettes. If anybody expresses an interest in concerts or shows these will be organised. One person has a Saturday morning job in a local pub and one person is currently looking for a job. Three people attend college. One person is working towards independence. Meals are usually taken with the staff and lunch was observed to be casual and relaxed and inclusive of all the people living in the home. A visitor, who used to live in the house, had also been invited to stay for lunch to meet her friends. The visitor said she wanted to return to meet her friends and had been supported by staff to do so. All three kitchens were clean and tidy but there is a need for these especially Mill House, to be maintained for health and safety. Eastry Villas DS0000048300.V358702.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 know they will be supported in the way they prefer and that their physical and emotional needs will be met. People are protected by medication policies and procedures. EVIDENCE: People living in all three properties in Eastry Villas can expect to have their personal and health care needs sensitively supported by well-trained staff. There is a mix of male and female staff. A key worker system is in place and key workers have responsibility for 1 – 1 meetings to encourage people to voice their opinions and make choices. Staff have identified and risk assessed people who may safely use the kitchens. Several people living in two of the houses offered tea or coffee to the inspector and were able to safely access the kitchens to provide this themselves. Staff try to promote independence for people in their care. Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 15 Evidence was seen of how staff in Gore House have enabled a person with sight and hearing loss to be able to go for accompanied walks around the village. This has been done with considerable care and attention to detail such as providing photographs of routes and ‘touch’ areas. This results in all staff knowing how to aid that individuals independence as far as possible and in a manner that promotes confidence and enjoyment of the activity. This is thoughtful and good practice. Since the previous inspection, senior staff have undertaken approved first aid training, this meets a recommendation made at that time. All three houses operate a sound medication administration procedure. Storage is secure. Following medication training, staff must undertake in house training and are re assessed every six months. Health care professionals are involved with different aspects of care of people living in the houses. These include: - an occupational therapist, speech and language therapist, psychiatrist, community nurses, and local gps. Evidence for these was seen recorded in individual documents. Eastry Villas DS0000048300.V358702.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 are protected from harm by policies and procedures and by staff awareness and training about adult protection. EVIDENCE: There are sound complaints procedures and policies in Eastry Villas and complaints procedures are on display. Some staff were able to discuss the adult protection training they had received and were aware of the different forms of abuse. All staff has attended adult protection training. Induction also informs new staff about adult abuse and how to identify it. Complaints will be recorded on a format to indicate the progress and conclusion of any concern raised. Evidence was seen of records of money that is held by Eastry Villas. A sample seen of cash held and corresponding records was accurate. Eastry Villas DS0000048300.V358702.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 adequate This judgement has been made using available evidence including a visit to this service. People live in a homely and comfortable environment but until the new build is completed, some identified repairs being undertaken will improve health and safety. People live in a clean environment. EVIDENCE: An accompanied tour of all three properties in Eastry Villas was undertaken accompanied by the team leader and occasionally staff and people living there. All of the houses in Eastry Villas were clean and tidy but are let down by the general lack of maintenance and redecoration. This has not been undertaken as the houses are waiting for building work to be undertaken in the very near future. Major building works are due to start in February 2008. All three properties in Eastry Villas will be having some work done including altering room layouts and installing en-suites to all bedrooms and increasing lounge, dining and Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 18 activity spaces. This will be of great benefit to the people living in the houses and will enhance their lifestyles. The team leader and some staff said they had lots of plans for decoration and for improved activities including a sensory room when the building work is complete. In the meantime some areas especially the kitchen in Mill House and some wooden pipe covering in a bathroom must be attended to for safety. The team leader agreed to organise repair of the pipe covering immediately. The kitchen has few remaining doors or drawer fronts and this can cause a hygiene problem as it allows the contents to become dirty through general heat and steam found in any working kitchen and through movement of people in and out of the kitchen. It also looks very unsightly and does not enhance an otherwise homely environment. Although it is recognised that this is has not been maintained because of the building plans, a recommendation is made for suitable covering for these areas. It is a credit to the staff that the kitchen remains as clean as it is in these circumstances. Despite the lack of refurbishment, the staff have encouraged people to arrange their own rooms to suit their individual choices and these were very homely and personal. Forge House has two people living there and both were very welcoming during the inspectors visit. Staff were encouraging to one person who eagerly awaited football information on the tv. The house has a small front garden and is situated on the main road by similar properties nearby. Not all windows have restrictors on and some were seen to be wide open with enough space for people to fall from. Although some risk assessments have been made, a requirement is made for these to be reviewed including possible access by other residents in any individuals’ bedroom. Staff undertake infection control training. Laundry is mostly undertaken in the main co-owned house on the site and some laundry is undertaken in the houses. Eastry Villas DS0000048300.V358702.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 good This judgement has been made using available evidence including a visit to this service. People are supported by competent and well trained staff. People are protected by the homes recruitment procedure. EVIDENCE: Staff files could not be seen as the Registered Manager was on leave and the files are secured in her office. Some staff confirmed that they had had to provide references and CRB checks before starting employment. The team leader said that she always followed up references with a telephone call. New staff receive induction training and an example of an induction book was seen. New staff have to shadow another member of staff for two weeks before working on their own. Supervision is undertaken regularly. Staff said that the training given by the company is very good. One member of staff said it was ‘excellent’ another said it the amount of training provided Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 20 by the company was ‘unbelievably good’. There was evidence of certificates on display in offices for a wide selection of training courses. More than 50 of the staff has achieved or are completing NVQ 2 or 3 and others are due to start. Two new staff are being recruited to cover maternity leave. Eastry Villas DS0000048300.V358702.R01.S.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People benefit from a well run home and know their views are sought depending on individual understanding and communication. Peoples’ health and safety will be improved when some maintenance is completed. EVIDENCE: The Registered Manager is qualified and is manages all three of the homes making up Eastry Villas. Staff said she was supportive and approachable. The Registered Manager was on leave at the time of the inspection and some confidential records such as staff files, were therefore not available as they were locked in her office. Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 22 A senior member of staff and support workers are based in each home. A senior member of staff said that Eastry Villas had recently reformed dedicated teams for each property and this was an improvement on the previous system of staff working wherever they were needed. The senior went on to say that this meant people living in the home had a consistent group of staff caring for them. There is a mix of male and female staff in Eastry Villas. A team leader manages all three groups of seniors and support workers and is overseen by the Registered Manager. The Registered Manager has regular meetings with the team leader. A quality audit is undertaken regularly including medication, finance, health and safety and care plans. A senior member of staff confirmed that although seniors and support workers made the changes to care plans as they were required, they were then approved by the company’ s ‘client care department’. The client care department may also be contacted if staff has any query about the health and welfare of person living in Eastry Villas. Although the team leader could not confirm if the results of audits were collated and an annual report written, she believed that the Registered Manager was currently reviewing this. No maintenance certificates were available to be seen at this visit, however, the last report states that all equipment is regularly serviced. The fire log and assessments were up to date. Some general repair will benefit people until the proposed building is completed. Staff and seniors and the team leader have regular meetings including 1 –1 between key workers and people who live in the home. Eastry Villas DS0000048300.V358702.R01.S.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 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 2 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 2 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 24 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 2 Standard YA42 YA42 Regulation 12 (1)(a) 23 (4) (b) Requirement Review assessments for window restrictors. The sleep in room in Forge House is to be assessed for an adequate means of escape in the event of fire. Timescale for action 08/02/08 08/02/08 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 YA6 Good Practice Recommendations The service user plan format needs to be redesigned so that it is presented in a way that means more to service users. Where possible service users should be supported to be involved in its design and contents. The kitchen in Mill House must have storage items covered for health and safety. 2. YA24 Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection 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 Eastry Villas DS0000048300.V358702.R01.S.doc Version 5.2 Page 26 - 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. 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