Care Home: Healy Drive , 1

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What the care home does well Staff enable people to make choices and treat them with respect. The weekday activities provided are varied and suited to people`s individual needs. The house is clean and homely and people are able to personalise their rooms. The home is well managed and the staff team is experienced and well trained. What has improved since the last inspection? The laundry has been repositioned so that the office could be expanded. The office was originally very small and it was difficult for the staff to run the shift and for the manager to carry out her work together in the same room. What the care home could do better: The way the home manages the medication is to requirement but guidance is needed about how to make changes to the medication recording sheet. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Healy Drive , 1 Healy Drive , 1 Orpington Kent BR6 9LB     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: Ann Wiseman     Date: 2 6 0 9 2 0 0 8 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. the things that people have said are important to them: They reflect 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 © (2008) 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: Healy Drive , 1 Healy Drive , 1 Orpington Kent BR6 9LB 01689870216 01689891407 cabrini@cathchild.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Joanna Tripp Type of registration: Number of places registered: The Catholic Children`s Society care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 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 Cabrini, 1 Healy Drive is part of the Catholic Children?s Society and provides care for eight people with Learning Disabilities. The home is a modern, large, detached house situated in a quiet cul-de-sac and is part of a group of three houses, two group houses and a day centre for people to attend if they choose to. Everyone has their own spacious bedroom, there is a comfortable sitting room, large dining room and the garden is attractive and well maintained, with a sensory area that has easy assess from the sitting room. There is an area of decking by the French windows enabling 8 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home outside dining. The house has its own transport so people have trouble-free access to the community. 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 was an unannounced inspection; we arrived at 9am in the morning and left soon after 3pm. The manager was not on duty but the deputy manager facilitated the inspection, which she did in an open and helpful manner. Whatever files and documents we asked to see were quickly produced and were well ordered. During the day we had a look around the home and talked to some of the staff. All of the people who live in the home were out at their day centre. We looked at files belonging to three people and the available information of three of the staff. We also assessed some of the homes policies and procedures and sampled a random selection of the health and safety files and records. Care Homes for Adults (18-65 years) Page 6 of 28 Before the inspection the manager has sent us the Annual Quality Assurance Assessment (AQAA) she had completed. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the service. The AQAA was sent to us within our set timescales and showed that the home recognised areas that need further improvement. We had sent surveys to the home for distribution amongst the people in the home, their relatives and the staff. Unfortunately at the time of writing this report we have not had any of them returned. The house was clean and tidy and whenever we have visited it in the past the atmosphere has been happy and congenial, interaction between the staff and the people living in the home was observed to be friendly and open. When staff talked about the people they did so in a supportive and respectful manner and written notes were also written appropriately. The program of redecoration and maintenance is ongoing and the house is well maintained. 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. People thinking of moving into 1 Healey Drive are offered enough information to enable them to make an informed choice about moving and everyones needs are assessed before they move in. Evidence: The homes statement of purpose was updated in August 2007 and is available in a clear and comprehensive format. People are provided with a contract that sets out the terms and conditions of the placement. We examined two peoples files during this inspection and they contained community care assessments, written contracts and care plans derived from the assessments. People thinking of moving in are given the opportunity to visit the home before they make a decision. We saw evidence that one person who moved in had three visits to the home, including a tea visit and overnight stays, prior to moving in and there had been a review before the placement was made permanent. Care Homes for Adults (18-65 years) Page 10 of 28 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 living in this home have care plans and are assisted to make decisions about their life and are consulted about the way they want to live. People who live in the house are enabled, through risk assessments, to take some risks as part of an independent lifestyle. Staff are trained to respect confidences and to handle personal information in a way that will maintain confidentiality. Evidence: Two care plans were examined, they reflected the needs and aspirations of the person involved. They have been updated since the last Inspection and have been reviewed at regular intervals. People who live in the home make decisions about the home and the things they do, they are supported to chose the menus and take it in turn to prepare and cook the food assisted by the staff. House meetings are held where everyone gets a chance to make suggestions for what they would like to do when they go out. Risk assessments are developed to minimise Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: risk of harm in all of people every day activities. Induction training includes keeping confidences. When not in use private information is stored in a locked cupboard in the office and is not left lying around in communal areas. 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. People are able to advance their personal development by attending a day centre and Adult education classes. A full range of activities is offered in and out of the house that makes people a part of the local community. Friends and family are welcomed in the home and peoples rights and responsibilities are recognised and upheld. Food offered is varied and people take it in turn to help prepare the meal. Evidence: We were told that people enjoy using the homes computer, reading, cooking and attending classes at the local education centre. They go to a day centre where they are able to mix with their peers, people can chose to attend the day centre attached to the service or any of the local centres on offer. They enjoy eating out as a group or individually, they also visit the local pub and going to the cinema. Other activities offered include rides out to the coast in the house mini bus, swimming, gym club and Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: horse riding. Friends and family are welcomed in the home and often visit or are invited to help celebrate special events. Some people go to visit their families at home. People are helped to keep their rooms clean and tidy and choose and prepare the evening meal, there is a rota of chores that each person is responsible for within the home. The menu is varied and offers a balanced diet, the food cupboards freezers and fridge were well stocked with fresh, tinned and frozen food as well as snacks and treats. 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. This home records peoples personal care needs in a way that enables them to be supported as they want to be. People have access to doctors and specialist care and medication is managed properly. Evidence: We looked at two care plans and found that, peoples support needs were recorded and they were written in a way that reflected peoples personal preferences. For example they would mentioned if a person preferred to have a shower or bath. The care plans were reviewed regularly enough to give people an opportunity to change their minds about how they want to receive personal care. We found evidence, in the files we examined, that people have access to medical practitioners as and when they need to. They also get support from specialists such as speech and language therapy, psychology, psychiatric, dentists and opticians. We examined the medication and its records and found that they were mainly as required. There were occasions when the medication was written in the chart by hand. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: This is a practise that should be avoided, but if it is unavoidable then extra care should be taken and the task must be done by two people and signed as correct by both. Any slight mistake, such as a decimal point being put in the wrong place, could put peoples lives in danger. The record sheet should record if someone has an allergy to any medication, but the area was left blank. To avoid confusion they should be completed, if only to record no allergies known. The deputy manager is responsible for ensuring that the medication is correct and audits the medication and records at regular intervals and keeps records of the check. Our professional website is available to everyone and contains guidance on many topics including the safe management and recording of medication. 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. Complaint policies and procedures are as required and complaints are investigated. Systems are in place to properly record complaints and concerns. People are protected from abuse by staff being properly trained in safeguarding and managing challenging behaviour. Evidence: The home has complaint and safeguarding policies in place and the procedure is displayed throughout the home. Complaints and concerns are recorded in a way that makes it possible to easily follow them from start to finish. We have received an allegation, regarding the management of the service, that was made directly to us by someone that wants to remain anonymous. We asked one of the charity directors to investigate the allegation, which they did and took appropriate action. We are happy with the outcome. The concern did not affect the welfare of the people living in the home, and those involved have been reprimanded and have received redirection. We examined the way that the home looks after peoples personal money. The money spent is recorded and receipts are kept. Peoples money in the home is stored in individual purses that are locked away in the office for safe storage. We examined two purses and found that the amount of cash in the purses corresponded to the totals Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: recorded in the cashbooks. A copy of the Multi-Agency Vulnerable Adult Protection document No Secrets is available for staff. Recent training has covered safeguarding adults and managing challenging behaviour. 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. This home is safe, comfortable, clean and hygienic. Bedrooms suit peoples needs and lifestyle and there are sufficient bathrooms and toilets. Evidence: The home is in an attractive building; it is homely and well decorated. There are lots of photographs displayed of people while on holiday and out and abouy, there also some plants around the home. There is a large attractive garden that is planted with trees and bushes, there is also a large grasses area and a pond. It is accessible to everyone via ramps from the sitting room. There have been some changes to the layout of the house since the last inspection. The Landry has been moved and is now more spacious and the office has been extended into the old laundry so that it is much bigger and is now better organised. All of the communal rooms are clean and hygienic and bedrooms are individual and reflect the personality of the people who occupy them. There are sufficient bathrooms and toilets to meet peoples needs and some have been fitted with equipment and aids to maximise independence. Care Homes for Adults (18-65 years) Page 20 of 28 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. Staff are aware of their roles and responsibilities and are qualified. The home has recruitment policies and procedures in place that are being followed. Training is in place. Staff are receiving supervision. Evidence: Staff personnel files are kept at the Catholic Children’s Society office in Purely, Surrey and are open to inspection on request. We did not examine the files on this occasion, but when we have done so in the past they held all the information and documents that are required. We spoke to two staff members on this occasion. They confirmed that all the checks that safeguard people are being carried out before staff start work. The home uses volunteer workers, which are foreign students on a gap year. Each volunteer undergoes CRB checks in both their own country and Britain, they are supervised and receive training. The volunteers supplement and do not replace paid staff. The two staff members we spoke with knew their roles and responsibilities, they displayed a good knowledge of the people in the home and understood their needs. Information given to us in the Annual Quality Assurance Assessment (AQAA) Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: completed by the manager tells us that the home has met the minimum of 50 of it’s staff having attained the NVQ 2 in care or it’s equivalent. Levels of staffing is adequate to offer the eight people individual uninterrupted time, continuity of care and to be able to manage emergency situations. The rota shows there are always three staff members on duty each shift, including one volunteer. The home offers a wide range of training, in the last year staff have received training in managing challenging behaviour, health and safety, midas minibus training, manual handling, protection of vulnerable adults, basic food hygiene, risk assessments and communication and signing. The manager has highlighted the need to source training around the changing needs of people in their care such as ageing and age related illness. Staff have reported that they receive supervision. Although we did not see the supervision notes on this occasion the deputy manager has also told us that supervision is carried out and information in the AQAA confirms this. 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. This home is well run and the ethos of its management is empowering to the people living in it, their views underpin its running. The policies and procedures and the record keeping protect people’s rights and best interests and health and safety is promoted and necessary checks are made and records kept. Evidence: The manager wasnt at the home during this inspection but when we have visited in the past we found that she was organised and is well liked by the people living in the home as well as the the staff. She is working towards obtaining her NVQ4 in care and her registered manager’s award and has managed the home since 2001. She is supported by a deputy manager, cleaning staff and a handyman as well as the care staff. There is Line management and admin support on site. In the managers absence the deputy manager facilitated the inspection, she was able to find everything we asked for and was knowledgeable about the running of the home and the people living in it. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The home sends annual surveys to staff, people in the home and their relatives. Once they are returned the information is collated and action is taken when shortcomings are highlighted. This years surveys have already been sent out, at the time of the inspection the manager was waiting for them to be returned. House meeting are held where people are encouraged to speak their mind about how the home is run and how it can be improved. Records are kept of these meetings and we were able to see them. The organisation’s polices and procedures are comprehensive and are reviewed and updated as legislation dictates. Records are kept up to date and are stored appropriately. Personal details are stored in a locked cupboard in the office and are not left unattended, staff are asked to read and sign the organisations policy on confidentiality when taking up post. A sample of health and safety records were inspected and were found to be in order. A fire risk assessment has been carried out and the fire folder contains a floor plane showing where fire points, extinguishers and sensors are placed. Fire points are tested weekly and fire equipment is tested annually. Fridge and freezer temperatures are taken and recorded daily, the environmental health officer last visited in August 05, there were no areas of concern. 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 20 Occasionally it is necessary to record medication by hand on the recording sheet. It is recommended that the manager reminds staff to avoid entering new medication on the chart by hand, and that if they cant avoid it they should do it in a way that will protect people from harm. To avoid people being given medication they may be allergic to, the medication records must be completed fully. It is recommended that relevant information is passed to the pharmacist so they can include it on the record sheet. 2 20 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 © (2008) 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. 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