Care Home: Essex Care Consortium Marks Tey

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What the care home does well Staff continue to be very open and focussed upon achieving the best outcome for service users. The premises are well furnished, homely clean and safe. The organisation maintains comprehensive policies and practice procedures. The organisation has consistently achieved externally validated quality assurance and an Investor In People Award; this award focuses on staffing, supervision and training. What has improved since the last inspection? The service was operating at an good level at the time of the previous key inspection and this has not been exceeded. What the care home could do better: No requirements were made as a result of this key inspection; the service should continue to build upon its firm foundation of current practice to further develop positive outcomes for people using the service and to take it to the next level. CARE HOME ADULTS 18-65 Essex Care Consortium Marks Tey Station Road Marks Tey Colchester Essex CO6 1EE Lead Inspector Neal Cranmer Unannounced Inspection 11 and 14th April 2008 09:00 th Essex Care Consortium Marks Tey DS0000017967.V362264.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 Essex Care Consortium Marks Tey DS0000017967.V362264.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. Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Essex Care Consortium Marks Tey Address Station Road Marks Tey Colchester Essex CO6 1EE 01206 211825 01206 211825 ecareinfo@btconnect.com www.e-care-c.co.uk Ms Bethan Jess Oliver Ms Gillian Oliver Patricia Owen Care Home 13 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) Category(ies) of Learning disability (13) registration, with number of places Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 13 persons) 3rd May 2007 Date of last inspection Brief Description of the Service: The service is comprised of three dwellings occupying the same site. The largest dwelling provides for eight younger adults, who have a learning disability. The bungalow accommodation enables each person to have their own bedroom and to share other communal spaces. The second dwelling is a smaller bungalow accommodating four adults with similar disabilities, although persons within this bungalow have more complex needs. This dwelling is selfcontained and provides each person with separate facilities. The remaining dwelling consists of a self-contained studio flat on the ground floor, which provides for one person. The weekly fees were advised by the manager at the time of the site visit as being £688.04 to £1942.65. Essex Care Consortium Marks Tey DS0000017967.V362264.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 two stars. This means the people who use this service experience good quality outcomes. This report is the outcome of a key unannounced inspection, which focussed on the key standards relating to care homes for young adults. The site visit was undertaken on a weekday and took place over approximately 8.00 hours. The report has been written using accumulated evidence gathered prior to and during the site visit, including the homes ( AQAA) Annual Quality Self Assessment. The inspection process included examination of a range of documents including staff training and recruitment records, three service users files, a selection of policies and procedures and health and safety records. The inspector also toured the premises and grounds and spoke with service users and staff. The registered manager was present throughout the inspection and contributed fully to the inspection process. What the service does well: What has improved since the last inspection? What they could do better: No requirements were made as a result of this key inspection; the service should continue to build upon its firm foundation of current practice to further develop positive outcomes for people using the service and to take it to the next level. Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 6 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. Essex Care Consortium Marks Tey DS0000017967.V362264.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 Essex Care Consortium Marks Tey DS0000017967.V362264.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): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have all the information they require to make choices about the service. The policy and procedure regarding admissions to the service reflect good practice and ensure appropriate transition into the service. EVIDENCE: Both the home’s Statement of Purpose and Service users Guide had been reviewed since the previous inspection, both documents contained comprehensively detailed information to enable service users to make an informed choice about the home’s ability to meet their needs, both documents were available in an easy read and symbol format for ease of use by service users. Since the previous the inspection there has been one new admission to the home, the initial assessment for admission is carried out by the registered manager and one other who make an initial determination on the home’s ability to meet the persons needs. The needs assessment covered the following areas: Likes and dislikes, personal care needs, health, emotional needs, relationships, diet and nutrition and spiritual needs. Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 9 If the initial assessment is positive then the persons social worker is notified, arrangements for visits are made, and Statement of Purpose and Service users Guide are provided. Transition arrangements are geared to the individuals needs, and may include overnight, weekend and tea visits. The transition report for the person newly admitted evidenced that six visits were made to the home prior to admission. The initial twelve-week period in the home is on a trial basis, following which an interim review is held. During the initial twelve-week period a care plan is not developed, support is based around initial guidelines developed from a range of sources including family, college, and social worker. A full plan of care is developed following the interim review. Essex Care Consortium Marks Tey DS0000017967.V362264.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): 3, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from the care planning approach to enable choices and decisions about their lives including taking responsible risks. EVIDENCE: Care planning arrangements were sampled using three service users files as a case tracking exercise. The care planning structure is well planned and provided staff with clear guidelines to staff, in addition there was data relating to risk assessment from which care decisions are made. The plans viewed indicated that the approach was with the consent and co-operation of the service user. The organisation has developed an environment of ‘inclusive communication’ and this continuity of approach is underpinned with actions throughout the organisation as far as practicable. Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 11 Discussion with the registered manager and the ‘inclusive communication coordinator indicated that care plans were currently undergoing significant review to enable the inclusion of the Mental Capacity Act. Overall, the practice that underpins care planning is ‘person centred’ and individual. Discussion with service users indicated that they were involved in the development of their care plans. The service has a suitable risk framework and the tools used are appropriate to safeguard service users whilst encouraging maximum independence. The file management was observed to meet the requirements of confidentiality and security. Essex Care Consortium Marks Tey DS0000017967.V362264.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): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported to take part in appropriate activities both in the home and within the wider community. They can also expect the home to enable them to maintain personal and family relationships. EVIDENCE: It was only possible to speak with service users briefly on the first day of the inspection, as they were due to leave to attend the Access centre, from where they go to the institute to attend courses on life skills, communication and sports. One service user spoke of travelling to college fully independently, and another spoke of working alongside the maintenance staff, a job for which they were paid. A further three service users are on the waiting list of a local employment agency. However during brief discussion prior to their leaving for college the inspector was able to gather from them that they accessed the community in the following ways: using the local shops, going to the local bowling alley, visiting the local cinema, going trampolining, going for occasional meals out, and one service user had joined a local boxing club. Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 13 Although only able to speak to service briefly at this point the inspector we returned on the second day of the inspection to spend more time chatting with the service users to gain their views. The home has an open door policy on the receiving of visitors, and the home’s visitor’s book indicated a high turnover of visitors to the home. All of the service users have key workers, all of whom they were aware of who assists them to maintain links with their families and friends through the sending of cards and letters as well as telephone calls. One service user stated ‘my key worker helps me to wash my hair’ another said’ they help us to arrange new bus passes’. All of the service users said that the staff were always polite and respectful, and always knocked on their doors before entering. The home operates a weekly menu, which service users are encouraged to assist in setting. Service users assist in the shopping process. Discussion with the service users indicated that they assist in the kitchen with the preparation of the vegetables, setting of the dining tables, washing and drying up, and the mopping of the floors. All said that the menu is displayed on the wall, and that they were aware of what was for tea in the evening, they also said that the food was nice, and that a range of choices was available. Essex Care Consortium Marks Tey DS0000017967.V362264.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): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to receive appropriate personal support, and that their healthcare needs will be fully met. EVIDENCE: Based upon the sample of care plans all service users are registered with the local GP practice. Healthcare matters, including optician and dentist are planned in advance for each person. Appointments are taken within the community in keeping with the ethos of the service unless it is necessary for a home visit in the same manner as anyone living within the community. From the sample files examined it was noted that the healthcare part of the plan was well designed and enables easy tracking of healthcare appointments and follow up actions where necessary. The arrangements for service users prescribed medicine were reviewed. Most service users have their prescribed medicines held in safe custody by the service and care workers administer medicines. The service operates a monitored dosage system (MDS) supplied by a well-known local pharmacy. The medicines are securely held when not in use within a steel lockable cabinet. At the previous inspection concerns were raised about the home’s Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 15 medication recording practice, in light of these concerns mechanisms were put in place for monitoring and auditing medication, these audits are now carried out weekly by the registered manager. Medication is now always administered by two staff, one administering and one witnessing, sampling of records showed that there were no gaps or omissions. Each service users medication record includes a photograph of the individual as well as a record sheet of prescribed medication along with any possible side effects. All staff working in the home administer medication, but only upon completion of external training provided by local pharmacists, in addition to this training they undertake three observations of practice carried out in-house. The practice in the home is now good and ensures that service users are protected by the homes practice. Essex Care Consortium Marks Tey DS0000017967.V362264.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): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to be protected by the home’s policies and procedures on dealing with complaints and adult protection matters. EVIDENCE: The service maintains a complaint procedure, which is available in easy read and symbol format for those who would find it easier to access and understand. In addition to this the home provides complaints leaflets specifically for: Staff, relatives, advocates, and external professionals and contractors. The Manager advised that no complaints have been investigated during the period since the previous inspection although written compliments received by the service had been received. The format of the complaint procedure and its use remains the same as at the previous inspection and therefore continues to comply with National Minimum Standards, and ensure that service users are adequately protected. The service has in place a safeguarding adults policy and procedure, and in a similar way to complaints, the format is made easier for people by easy read and symbol formats. There have not been any adult protection referrals made in respect of the home since the last inspection. Discussion with the registered manager indicated that all staff have been provided with adult protection training, and all staff are provided with a copy of the policy in the staff handbook that they are provided with at the commencement of their employment in the home. Discussion with staff indicated that they were aware of what to do in the event of an allegation being made. Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 17 Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a safe, homely, comfortable, clean and welcoming environment. EVIDENCE: The bungalow environment remains well maintained, clean, well furnished and decorated. The environment, overall, is domestic in appearance and comfortable. The dwelling was clean and there were no unpleasant odours. Overall the standard of accommodation is very good. Externally the premises remain well maintained and safe, there were extensive grounds in which the service users were free to wander at their leisure. During the course of the site visit maintenance staff were on site replace the facia boards on one of the bungalows. Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 19 The manager reported that further remedial repair work across the site was scheduled, to include the replacement of windows, further fascias, and a general programme of redecoration. Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to have their needs met by a well trained, and competent team of staff. Further more they are safeguarded by a thorough and robust recruitment procedures. EVIDENCE: The home has a dedicated staff training office who is based at the organisation’s main site the other side of Colchester. Discussion with the training officer indicated that since the last inspection the following training has been provided in the home: Medication administration, Physical interventions, inclusive communication, equality and diversity, mental capacity act, N.V.Q level 2, 3, and 4. Six pack training including: appointed person’s first aid, health and safety, fire safety, adult protection, manual handling and food hygiene. To assess whether six pack training has been beneficial the organisation has developed an assessment tool which staff are required to complete following the training to evidence knowledge and awareness. Newly appointed staff to the home are inducted over a twelve week period, the first two weeks purely focussing on policies and procedures, and completing the common induction standards, the next few weeks are spent shadowing Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 21 more experienced staff, how long the shadowing period lasts is dependant upon previous knowledge and experience. Following this new starters then follow the rota pattern. The home employs 20 care staff; of these over 50 hold National Vocational Qualifications (N.V.Qs). Three staff files were sampled as a case tracking exercise to assess the service practice regarding recruitment. The recruitment practice for all three was sound, and included evidence of application form, two written references, criminal records bureau check, including POVA 1st check. Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to be cared for in a home that is competently managed and run in the best interests of the people who live there. EVIDENCE: The Manager has been in post for an established period and is both appropriately qualified and experienced. The management style within the service is, overall, well organised and delivered within a relaxed and supportive manner. The ethos is one of encouragement and pro-activity. The organisation has achieved a standardised, externally validated, quality assurance scheme in addition to the Investors In People Award. At the time of inspection the quality approach was focussed on service user meetings, which were taking place monthly, and were fully minuted, at each of the meetings National Minimum Standards are discussed. Copies of the Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 23 minutes of the meetings are sent to the organisations quality manager. The registered manager reported that as part of the organisations continual review process the quality review process itself was undergoing a review. The registered provider carries out Regulation 26 visits on a monthly basis and provides the home with a copy of the reports. Service users spoke of being spoken too during these visits. Discussion with staff indicated that staff meetings are held monthly. The service has fire detection systems, fire extinguishers, emergency lighting system, portable appliance checks and care of Substances Hazardous to Health (COSHH) strategy. Where appropriate, these systems are regularly checked by external contractors on a rolling basis. Safety certificates seen and in order included: electrical installation certificate, environmental health officer report, records of fire drills, record of fire alarm tests, record of emergency lighting tests, and record of tests relating to emergency call bells. On visiting all of the communal areas of the premises and the outside, no obvious health and safety matters were raised or were noticed. Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 24 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 4 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 25 No. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA24 Good Practice Recommendations It is recommended that the temporary wood cover fixed to heating radiators in the lounge area be removed and replaced with a fitted replacement part, so as to ensure that service users are adequately protected and to enhance the appearance of the respective rooms. Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Essex Care Consortium Marks Tey DS0000017967.V362264.R01.S.doc Version 5.2 Page 27 - 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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