Care Home: Fen Grove (76)

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What the care home does well We saw Fen Grove provides a homely environment for the people who live there. We saw good relationships between people who use the service and staff. We saw people to be relaxed and comfortable in their bedrooms and in the lounge and dining area. Relatives and health professionals said `an excellent care facility` and `they look after my relative very well`. Staff told us they have good training opportunities and have enough support from the manager. Staff say they provide person centred and individualised support, help provide good medical assistance and support people who use the service in their daily activities. What has improved since the last inspection? The service has worked to ensure the individuals privacy and dignity is respected and have provided a new screen in the shared bedroom. We saw bedrooms have appropriate furniture, bedding and furnishings. We saw evidence that appropriate medical advice has been sought to ensure peoples dietary needs are fully met. What the care home could do better: The service is aware that a private space needs to be found to be used as a staff office, for the storage of some records and to enable some conversations and staff supervision to be carried out. Information about the service in the Statement of Purpose and Service Users Guide need to be updated to ensure people have access to correct details. Consideration should be given to the manager attending safeguarding training through the local authority to keep her up to date with the people to contact in the event of any allegations or concerns. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Fen Grove (76) 76 Fen Grove Blackfen Kent DA15 8QQ     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: Emma Dove     Date: 2 0 0 1 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 28 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Fen Grove (76) 76 Fen Grove Blackfen Kent DA15 8QQ 02088508699 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : fengrove@mcch.org.uk MCCH Society Ltd care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care Home Only (CRH - 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 - Code LD Date of last inspection Brief description of the care home 76 Fen Grove is a care home, which provides care for up to four adults with learning disabilities. Maidstone Community Care Housing Ltd (MCCH) operates it. The home is a detached bungalow, situated in a residential area and within easy reach of local transport, services and shops. There is a large kitchen/diner, a lounge with patio doors, which open onto the garden and a small utility room. There is no dedicated office, so the utility room is also used as an office. The home has a bathroom with toilet and there is an additional toilet. There are two single bedrooms and one double and a large rear garden. At the time of the inspection, there were four people living there. Care Homes for Adults (18-65 years) Page 4 of 28 Care Homes for Adults (18-65 years) Page 5 of 28 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: This unannounced inspection was carried out over four hours on the 20th January 2009, by one regulation inspector. We spoke with people who use the service, staff and the manager and looked at records. Surveys were sent to some relatives of people who use the service, placing social workers, health professionals and staff. We received ten completed surveys, comments from which are included throughout this report. We received an annual quality assurance assessment (AQAA) from the manager in October 2008. This gave us good information about the service, what it does well, how it has improved and plans for development over the next year. Care Homes for Adults (18-65 years) Page 6 of 28 We also looked at other information from the service since the last inspection on 7th February 2007. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 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 9 of 28 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. The home understands the importance of having sufficient information when choosing a care home. Admissions are made after an assessment, which is updated to reflect any changes in the individuals needs. Evidence: The service has developed a Statement of Purpose and Service Users Guide which give people information about the home and services provided, to help them decide if the home is right for them. The Service Users Guide is in pictorial format, accessible to people who use the service. These documents include information about the aims and objectives of the service, details of the accommodation provided, the admission process, care plans, leisure activities, the fees and some key policies. These documents need updating to reflect the new contact details of the CSCI. We did not see assessments completed before people moved in. The manager told us these documents had been archived due to the time people have lived at the service and said they do not reflect peoples current needs. We did see details of peoples Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: current needs and how staff should meet them. Care Homes for Adults (18-65 years) Page 11 of 28 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 who use the service are invovled in developing and reviewing their care plans. Care is person centred to the individuals choice and preferences. Evidence: We saw care plans to be regularly reviewed and person centred. These documents detail what care and support the individual needs and how they prefer to receive care. Staff told us they have up to date information about peoples needs. Reviews are held every six months with relatives and others invovled as required. The service operates a key work system with one member of staff allocated to each person who uses the service, to keep staff, relatives and professionals up to date with any progress and changes. The manager told us they plan to record how they review peoples goals and wishes in the future. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: We saw staff have detailed knowledge of individuals and how to meet their needs. We saw some good relationships between people who use the service and staff. Staff told us they are developing objects of reference for individuals. This will help with communication systems, ensuring people who use the service understand what is going to happen and are invovled. Care Homes for Adults (18-65 years) Page 13 of 28 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. The service is commited to enabling people who use the service to develop and maintain their social, emotional, communication and self help skills. People are supported to maintain important family relationships. People participate in activities of their choice to meet their needs. People are offered a varied menu which meets their dietary needs and preferences. Evidence: The manager told us the service offers people choices and provides a supportive environment for people to develop their skills. We saw people participating in activities in the home and out at day centres during our visit. Staff told us people go out bowling, to the cinema, theatre, shopping and to a hydrotherapy pool every week. People have aromatherapy at the home twice a week. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: People told us they enjoy swimming and watching television. We saw people relaxing, listening to music and spending time with staff. The manager told us that people have the opportunity to go on holiday each year, last year they went to Wales and Hastings. We saw photographs of people enjoying their holiday last year. We saw that people are offered a varied menu which caters for their medical and cultural wishes and preferences. The menu is displayed in pictorial format which is accessible to people who use the service. We saw staff offering appropriate support to people with eating and drinking. I enjoyed lunch was a comment from one person. We saw other people enjoying drinks when they returned home. Care Homes for Adults (18-65 years) Page 15 of 28 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 who use the service receive appropriate support with personal and health care, in a person centred way. Peoples health care needs are well met and recorded. Medication is well managed. Evidence: The manager told us people who use the service are registered with a GP and see other health professionals as required. We saw records of appointments with details of any actions to be taken. The service has developed health action plans which contain very detailed information of the individuals health needs and how they should be met. One health professional told us the service always seeks appropriate medical advice and has good communication systems with health care professionals to ensure the needs of people who use the service are met. Medication is appropriately stored with Medication Administration Record Sheets up to date and signed by staff. The manager told us staff receive training in the administration of medication and have a competency assessment to ensure they are Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: following the procedures and keeping people safe. Staff confirmed that they complete training in medication and are fully aware of the policies they have to follow and the reasons why. Care Homes for Adults (18-65 years) Page 17 of 28 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. The service has clear policies for complaints and the protection of vulnerable adults. The manager and staff are aware of their responsibilities. The systems in place to manage the finances of people who use the service are good. Evidence: The organisation has an appropraite complaints procedure which is in pictorial format, accessible to the people who use the service. The manager and staff said they have a good knowledge of the people who use the service and can see through behaviour patterns when there are issues and work to address them. One relative was not sure that they knew how to make a complaint but said the service always responds appropriately to any issues raised. Records are kept of any complaints and any actions taken. The manager told us they have not received any complaints in the last year. No complaints or issues have been received by the CSCI. The service has policies for the protection of vulnerable adults and has a copy of the local authorities safeguarding policy. The manager and staff are aware of their responsibilities under these procedures and what they should do. It would be useful for the manager to attend training on safeguarding run by the local authority. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: The manager told us they hold some money for people who use the service. We saw the records and balance for one person, these were up to date, correct, signed by staff with the receipts together to show what the money was used for. Good systems are in place for checking finances on a daily basis. Care Homes for Adults (18-65 years) Page 19 of 28 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. The home is appropriate to meet the needs of the people who live there. The home is well maintained and kept to a good standard. Bedrooms have been personalised. All areas of the home are clean and fresh. Evidence: The manager said they have a person centred environment. We saw that bedrooms have been personalised to the individuals taste and preference and that the environment is suitable for the people who live there. People have access to a kitchen/dining room, lounge and large garden. There is a laundry room which is also used to store some records. The manager and staff are aware that this is not sufficient and told us that the organisation is in the process of looking at options to provide a safe, secure office for meetings and storage of records. Two people have a single bedroom and two people share a bedroom. The manager said the two people have shared for many years and seem to get on. A new screen has been fitted to provide some privacy for individuals when staff are supporting them with personal care. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: There are sufficient toilet and bathing facilities to meet peoples needs. There are ceiling hoists and equipment to ensure people who use the service are moved safely. Staff said they had training on how to use the equipment provided. All areas of the home were clean and fresh, with appropriate cleaning schedules in place to manage infection control and keep the home at a good standard. The manager said they are trying to invovle the people who use the service in the day to day cleaning of the home. One person told us that this was ok with them. Care Homes for Adults (18-65 years) Page 21 of 28 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. Staffing levels are sufficient to meet the needs of the people who use the service. Staff recruitment is in line with regulations, to keep people safe. Staff have access to appropriate training and have regular supervision with their manager. Evidence: We saw enough staff available to meet peoples needs. Two staff are on duty during the day with the manager available in addition to this most days. Staff demonstrated a good, detailed knowledge of the needs of the people who use the service. We saw some good interactions between staff and people who live there. Staff said there are always and usually enough staff to meet peoples needs. One survey indicated that having permanent staff rather than agency staff, means people get better care. We saw staff files contain confirmation that the checks required, including a Criminal Records Bureau check and references were completed before staff started work at the home. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Staff have access to training to help them do their job. Staff told us training they have is relevant to their job and helps them meet peoples needs. The manager said staff get supervision every six weeks but this may be a bit longer sometimes due to staff holidays. Staff told us they felt supported and see their manager regularly. Care Homes for Adults (18-65 years) Page 23 of 28 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. The manager has the knowledge and experience to run the home. The service is well run, in the best interests of the people who live there. The annual quality assurance assessment included clear information about what the service does well and how they plan to develop, with evidence to confirm this. Health and safety is well managed with records up to date. Evidence: The manager has experience working for the organisation and has been at the home for a number of years. She has a good knowledge of the people who live at the home, their needs and how they should be met. Good quality assurance systems are in place. A representative from the organsiation visits every month and checks records, speaks with people who use the service and staff and raises any issues to be addressed by the manager and the service. The manager said any issues raised are actioned with this recorded in the next monthly visit. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The manager sent surveys to relatives and representatives of people who use the service in January 2008, comments received were positive with no issues raised. Some comments included they keep me informed, the staff are brilliant, always made welcome and there could be more activities. The manager said they have worked on arranging more activities for people who use the service. The manager said that health and safety checks are completed at the appropriate intervals. We saw records confirming that the fire alarm is tested weekly and serviced every three months. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 1 The Statement of Purpose and Service Users Guide should be updated to reflect the changes in contact details for the CSCI, to ensure that people who use the service and their representatives are able to contact the Commission if they wish. Consideration should be given to the manager attending a training session on safeguarding through the local authority, to ensure she has up to date contact details and to provide local information. 2 23 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 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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