Care Home: Kemsing Road Respite Service

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What the care home does well The home continues to be good at ensuring that the people who use this service are supported appropriately in all aspects of their day-to-day living whilst visiting the service for respite care. This includes providing the necessary support to enable them to be a part of the wider community and to continue to have aspirations, expectations and goals that they would normally have when at their own family home. What has improved since the last inspection? Assessments care plans and care files are updated from updated CLDT reviews. Efforts are being made jointly by the home and CLDT to convey to relatives/carers the importance of reviews of not being cancelled unless unavoidable. Continued efforts are being made recruit staff that could drive the mini bus for the home. The broken chairs have been repaired and the bathroom tiling fixed. The frequency of breakdowns and subsequent delay in repairs to the washing machines has been rectified. The impact of the departure of the previous administrative assistant was reviewed and a new person has recently been appointed to this post. CARE HOME ADULTS 18-65 Kemsing Road Respite Service 11 Kemsing Road Greenwich London SE10 0LL Lead Inspector James Pitts Unannounced Inspection 8 & 12 August 2008 11:55 th th Kemsing Road Respite Service DS0000062951.V366303.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 Kemsing Road Respite Service DS0000062951.V366303.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. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kemsing Road Respite Service Address 11 Kemsing Road Greenwich London SE10 0LL 0208 269 1192 0208 269 0805 caretechkemsing@hotmail.co.uk 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) Caretech Community Services Manager post vacant Care Home 8 Category(ies) of Dementia (8), Learning disability (8), Mental registration, with number disorder, excluding learning disability or of places dementia (8), Physical disability (8), Sensory impairment (8) Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Learning Disability - Code LD Physical Disability - Code PD Sensory Impairment - Code SI 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 8 24th May 2007 Date of last inspection Brief Description of the Service: 11, Kemsing Road, is a purpose built semi-detached property, offering respite care and accommodation for up to 8 Service Users at any one time. This respite care is completely flexible, and can be for as little as one night, or for several weeks, depending on the current requirements. The property was built in association with Greenwich Social Services, to provide respite care in place of other Homes that were no longer suitable. The Registered Providers and management are Caretech Community Services, who are experienced providers for these categories of care. Accommodation is provided in 2 flats of 4 bedrooms each, with one flat on the ground floor, and one on the first floor. The second floor contains office and staff facilities, the laundry, and a clinical room. Each bedroom is provided with en-suite shower facilities, and suitable Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 5 equipment for Service Users with physical disabilities. The rooms on the ground floor are slightly larger, and are usually reserved for Service Users who are wheelchair bound. The 2 flats are provided with separate kitchen, lounge and dining rooms, a shared bathroom, and separate gardens at the rear of the property. These also have separate access from the Home. A passenger lift provides easy access to all floors. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means people who use this service experience good quality outcomes. London Borough of Greenwich Social Services Department solely and specifically contracts the service at Kemsing Road from the registered provider. The charge for the service is presently £1,637:03p block service contractual fee for the whole amount of respite care stays allocated to each person in each year. In the region of 51 people currently use this service and each are allocated a baseline of 35 respite care days (including overnight stays) per year. Not everyone chooses to use the total allocation. Where there are specific reasons for doing so there can be additional days added to the allocation of stays if assessed as being needed by the purchasing authority. This inspection took place over the course of two visits during the daytime and most of the people who live here were out, although some people were at home for parts of the day. Two people spoke about their specific positive view of the service and about their interests and activities. Everyone who uses the service, and their relatives were also provided with a questionnaire before the visit took place. From these questionnaires there were responses received from six relatives in total (amounting to approximately 12 of the total using the service). Three of these replies, although containing some positive comments also gave some negative views about the service, examples being, “I feel some staff have (the skills necessary) but personal care staff don’t seem to. Certainly not to the standard that families expect”, “(relative who uses the service) cannot keep up with changes in the staff team, he reckons there is not enough mix in the team” and “We have some problems with the care of our son. We have not been very pleased with the care our son has received”. Examples of positive comments from the three other relatives include “ We find the home very friendly and the staff are great. We have no complaints.” “The staff, as far as I am aware, always treat the people in their care with dignity and respect whatever their race, gender or religion” and “My son is always happy to stay there so that reflects the standard of care”. Needless to say these widely varying viewpoints should be explored by the home with relatives in more detail as a part of a review of the quality of service. In addition to the questionnaire feedback and conversations with people who us the service, discussion was also held with the manager, a senior management representative of the registered provider and other members of staff. Standard policies, procedures and required records were examined and information from the previous random visit, AQAA (Annual Quality Assurance Assessment), notifications made to the Commission and other relevant data was also considered. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: The Registered Provider must liaise with the purchasing authority to seek ways of improving the way in which updated care and support information is provided. Appraisals and personal development plans must be updated and staff must have at least the six minimum supervision sessions in each year. An Annual Development Plan must be written and a copy must then be sent to the local office of the Commission. (please refer also to the six recommendations that are made at the end of this report). Please contact the provider for advice of actions taken in response to this Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 8 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. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 9 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 Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 10 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): People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Standards 1 & 2 were assessed at this inspection. The people who use this service and others are told what the home does and how it will do it. The people who use the service can continue to feel confident that the home will only care for people that the staff are presently trained and able to care for. EVIDENCE: A requirement to update the Statement of Purpose and Service User Guide, made at the inspection of the home in 2006 had been complied with by the time of the previous inspection. Both documents continue to meet the required Standard. The home continues to use a set assessment format, and three were looked at in detail. These assessments included cultural and religious needs, physical / psychological health and medication. The assessment includes consideration of personal care and support requirements that include, personal hygiene; skills for dressing/undressing; aids and equipment required to support the care of each individual; nutrition, feeding and dietary requirements; mobility, and lifting and handling needs; sensory awareness; communication; social skills; Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 11 likes and dislikes; and any challenging behaviour patterns or safety issues. Pre admission daily routines are discussed to inform the care plan and to ensure that any ongoing attendance at college or day centres be maintained during the respite break. Some of those who use the service require community nursing support in addition to support by the permanent care staff team. Admissions to the service are conditional upon this support being available for the duration of the specific respite care stay for anyone who requires professional nursing input. It was noted in discussions during this inspection that the London Borough of Greenwich, as the authority that solely contracts this service, is looking to increase the provision of the respite service for people who require nursing care input. It is timely to state that the service is not currently registered to provide nursing care and an application to amend the conditions of registration would need to be made to the Commission (and be approved) unless community nursing services would continue to provide nursing care input. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 12 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): People using this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Standards 6, 7, 9 & 10 were assessed at this inspection visit. The people who use this can usually feel confident that the staff know what they need, although this could be undermined without further clarity in the care planning systems that are in use. They can, however, be assured that the staff will try their best to make sure that each person who comes to stay at the home is allowed to continue live the sort of life that they choose. EVIDENCE: Six care plans were looked at in detail during this visit. “Individual Support Requirements” are drawn up that specifically requires that staff members, the service user and or their representative sign to indicate their agreement or otherwise with the plan. Reviews occur, as was previously required and care plans are updated. Before each respite stay the relative (s) of the person coming to the home are asked to complete a form that states whether any changes to the person’s care needs have occurred. This is then supposed to Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 13 result in an update to the care plan that is kept at the home. There can be significant issues when these changes are not notified to the home, which poses a significant risk that changed care needs may not be identified or met by the staff team. For this reason it is required that the Registered Provider must liaise with the purchasing authority to seek ways of improving the way in which updated care and support information is provided. The home also appears to operate two parallel systems for recording care plan updates. One being a central reviewed plan and the other for updates received prior to each respite care stay (if and when this information is forthcoming). This poses a risk of confusion amongst the staff team as to which is the most current and up to date information about care and support needs. The manager, and senior management representative of the service, said during this visit that the care planning system is being completely revised in line with organisational review of the process. As this is the case a requirement will not be made in this report. However, the Commission will expect that the review be completed and that a revised care planning procedure be implemented. This is not least in terms of lessening the risk of confusion that could exist for staff with the present system. Staff are expected to write a daily support record. This is supposed to outline the individual care and support provided and any significant event during specific respite stay periods. Examination of a sample of these records showed that phrases such as “full support given” are being used as a description of events. That type of overarching phrase is meaningless, as it gives no real information about what has occurred. It is recommended that the service train staff in the use of proper and descriptive recording methods. Each person’s individual case file includes risk assessments that tell staff and other people about anything that may harm anyone who lives here and anything that the person might do that might pose a risk of harm to themselves. Copies of risk assessments are kept and cover a variety of situations from accessing community facilities to learning skills and activities within the home. Risk assessments continue to be reviewed regularly, however the risk assessment process should include common risks beyond the unique and individual risks that are currently recorded. The home has very clear procedures for staff about making sure that the personal information of the people who live here remains confidential. These procedures are designed to ensure that information is not shared with anyone who does not have a right to know. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 14 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): People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Standards 12, 13, 15, 16 & 17 were assessed at this inspection visit. The people who use this service can feel confident that the staff of the home will provide opportunities for everyone to develop their personal and social skills. This includes more active support for each person to participate in the community both in terms of the activities of daily life and leisure interests, although it is timely for the service to explore the provision of these opportunities even further. EVIDENCE: Many of the people who use this service have set days for attending Day Centres or colleges. Some may attend classes to improve literacy and numeracy, and/or develop new skills or leisure interests. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 15 Most of the people who come to stay here attend college or day centres from Monday to Friday, and the staff members of the home arrange activities, where possible, for evenings and weekends. As referred to in the previous inspection report the opportunity for evening activities may be restricted by the time taken for the admission process, the preparation of meals (which may include different diets), medication to administer, and personal care needs to be met. Activities may therefore be confined to music, spending time in the garden, or watching TV. Activities at weekends are more likely to include outings (e.g. to local shops, or places of interest); or visits to pubs, cafes or leisure centres. A weekly is required to be completed prior to the each person respite care stay arrival based upon the latest care information available. The second page of the document also serves as a communication both to and from carers and staff about updated information and the first page is copied to carers so they have a record of the activities provided. It was previously noted that the provision of outings and activities was hampered by a lack of staff members who could drive the mini bus provided for the home. It was then recommended that continued efforts be made to attempt to recruit new staff that could drive the mini bus. Further improvement has been made, however, the feedback from relatives who responded to questionnaires varied widely in terms of the perception of the range and type of activities on offer, particularly community based activities. It would be timely for the service to explore with those who visit Kemsing Road, and their relatives, the way in which activities are provided. Family members and friends are welcome to visit at any reasonable time, and staff members encourage maintenance of other friendships they may have. Respite care may be planned because the next of kin are on holiday, and therefore attention to facilitating other supportive relationships/friendships is of greater significance. The care planning files contained detailed information about maintaining nutritional needs, taking into account different food preferences, and specific diets. Menus are planned weekly, according to the different requirements and preferences of those coming into the Home for the next week. A set meal is prepared each evening, and a list of alternate choices is kept available (e.g. for soup, sandwiches, jacket potatoes etc.). The kitchens on each floor were seen and are clean, hygienic, and well equipped. Staff members usually do the shopping. Some kitchen cupboards are kept locked, and these include separate locked cupboards for knives and cleaning materials. There are separate handwashing facilities provided. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 16 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): People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Standards 18, 19 & 20 were assessed at this inspection visit. The people who use this service can remain confident that they will get the right support to take care of their personal and healthcare needs. Anyone who needs to take medicine regularly to help them stay well will get the proper support from staff to make sure that this happens properly and safely. EVIDENCE: The people who live here continue to make use of the range of community health services, although as they only come to stay for short periods of time most healthcare appointments are managed when they are at home with their own family. Each person’s unique and detailed health care support needs continue to be reflected in his or her care plan. A full medical profile is compiled which details the reason for prescription medicines and any risks that might arise about the use of the particular medication. Medicines are sent in by the individual’s relative (s) at the time of Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 17 each stay and are logged in to the medication records with date received, type of medication, strength, dosage and times of administration. The medication records for the people who were staying during this inspection were seen and all were in proper order. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 18 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): People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Standards 22 & 23 were assessed at this inspection visit. The people who use this service can feel confident that the staff team at the home know what to do if there are complaints or concerns about abuse. The home has clear guidance for staff about the procedures to be followed in either of these circumstances. EVIDENCE: The people who live here, and others, are given clear information about how to complain and what happens when they make a complaint. A total of twelve complaints have been received by the home since the previous key standards inspection. The outcome of all of these was recorded by way of written replies on a central complaint folder, although the logging sheet at the front of the folder had not been fully completed. It is recommended that the central log of complaints be recorded fully for ease of reference. Each of these complaints was responded to appropriately and no complaints have been referred directly to the Commission. There is clear written information for staff about what to do if they think that anyone who lives here is being hurt or abused by another person, or if an allegation is made. All staff complete training in the protection of vulnerable adults and have to complete refresher training at regular intervals. In feedback Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 19 from a relative prior to this inspection reference was made to a concern that arose over two years ago. As the concern had been investigated at that time and no further concern was referred to since the relative was referred to the placing authority with whom they have regular contact. One potential concern was raised with the home a short time ago about an unexplained injury. Subsequent investigation identified that this may have been an accidental injury that was caused whilst on local authority transport from a day centre and was not as the result of any incident at the home. No concerns or allegations of harm directly related to the care service have been raised with either the home or the Commission since the previous key standards inspection. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 20 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): People using this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Standards 24 & 30 were assessed at this inspection. The people who use this service can feel confident that they are living in an efficiently well maintained home, although this could be compromised if a refurbishment programme is not considered in the near future. The home is also kept clean and hygienic. EVIDENCE: Access to the property, can only be gained by a member of staff opening the front door from the inside, and there are security keypad locks in place on each floor to prevent service users from leaving the building unaccompanied. The Home was purpose built, and consideration has been given to ensuring suitably wide corridors for wheelchair users, and access to all floors via a passenger lift. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 21 Three previous requirements about repair to tiling and two chairs have been attended to. Overall, the standard of decoration was adequate although it would be timely to now begin to think about a refurbishment programme, as some areas of decoration are looking worn. The carpeting on the ground floor should also be considered for replacement at some point in the not too distant future. The laundry room is fitted with 2 industrial quality washing machines and 2 tumble dryers and a red alginate bag system is used for dealing with soiled items. The manager stated that the previously numerous breakdowns to the washing machines has been attended to, although one did again breakdown the day before the start of this inspection but this was imminently to be repaired. Each person’s laundry is washed separately. The Home continues to be clean throughout and hazardous substances are stored in accordance with COSHH regulations. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 22 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): People using this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Standards 31, 32, 34, 35 & 36 were assessed at this inspection. The people who use this service can feel confident that there are enough people working each day and they are safe people to take care of them. They can also be assured that the company that owns the home are doing what they can to make sure that there are sufficient numbers of staff that are properly qualified. These positive procedures could, however, be undermined if staff performance and training is not appraised at least annually and if they are not supervised regularly. EVIDENCE: The home has a complement of fifteen carer staff, four, of whom, are team leaders/care coordinators. From this staff team there are some staff vacancies as follows: 10 hrs per week (1 night) part time waking night care post, 20 hrs per week part time senior support worker post and 3 full time support worker posts. The manager stated that a current recruitment drive would hopefully lead to most if not all of these posts being filled in the near future. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 23 The registered provider carries out checks to make sure that the people who work here are safe people to work with the service users. These checks include things like asking the police if a new member of staff has ever been found guilty of a crime, and asking people who used to employ them if their work was good and if they are the right sort of person to work with the service users and to support them. The Commission accepts that the home is run by a larger company that has a central personnel department that original copies of these checks can be kept there. The home continues to achieve the minimum requirement of fifty per cent care staff qualified to level 2 NVQ or above. The staff team continue to have access to a comprehensive training and development programme. Appraisals were not in evidence on any of the staff records that were sampled. Appraisals and personal development plans must be updated for all staff who have not had these processes undertaken in the previous twelve months in order to evaluate performance as well as identify training needs for the coming year. It was identified that supervision records showed that some staff had not received supervision at least six times in the last year. A requirement will be made in this report to ensure that the service must achieve the necessary success with addressing the need for all staff to have at least six supervision sessions within any given twelve month period as is required by regulation. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 24 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): People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Standards 37, 39 & 42 were assessed at this inspection. The people who use this service can feel more confident that they are living in a home that has effective management oversight. EVIDENCE: The manager, just after the dates of these inspection visits, began the process of applying for registration with the Commission. This person was the registered manager of another Caretech service and transferred to this home in May 2008. She is very familiar with the range of needs of the people who use the service and the way in which the registered provider operates. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 25 It was noted at the previous inspection that the 20 hours per week administrative support that was provided to the home was ending due to the person in this post having resigned. A new administrative officer has recently been appointed and this support is continuing as was previously recommended. Monthly visits under Regulation 26 are occurring and copies of the reports of these visits are being kept at the home, although the service should be mindful of undertaking these visits in the same calendar month and not retrospectively. Given the viewpoints expressed about the variable quality of service that is perceived by some relatives this should be explored further by the home and registered provider. Given the recommendation made in the previous sentence it should be noted that the service has recently introduced a feedback system for relatives to respond to after each respite stay. This, if successful, should do much to improve the home’s response to any views about the quality of the service in a far more efficient way. There is presently no annual development plan for this service. An Annual Development Plan must be written and a copy must then be sent to the local office of the Commission. The necessary health and safety checks have all been completed and fire alarms are being tested at regular intervals as required. It was previously recommended that the manager of the home at the time of the last inspection contact the local environmental services department to find out when a visit is next due. As these visits are usually unannounced and are no longer an annual procedure they can often be far less frequent than used to be the case. Should the current manager believe that a visit is necessary due to any concerns then contact should be made to specifically request one. A fire alarm maintenance report, dated 11/06/08, stated that the fire alarm system requires replacing but gave no further detail as to why. An immediate requirement notice was issued during this inspection as a result. Subsequently it has been confirmed that the fire alarm system underwent a further maintenance check, some parts were replaced as they were showing signs of wear and the system is fully operational. The immediate requirement notice that had been issued has now been complied with and so will not result in a further requirement in this report. Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 3 LIFESTYLES Standard No Score 11 X 12 2 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 2 X X 3 x Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 14 (2) (a) & (b) Requirement The Registered Provider must liaise with the purchasing authority to seek ways of improving the way in which updated care and support information is provided. Appraisals and personal development plans must be updated for all staff who have not had these processes undertaken in the previous twelve months in order to evaluate performance as well as identify training needs for the coming year. The registered provider must ensure that the service achieve the necessary success with addressing the need for all staff to have at least six supervision sessions within any given twelve month period as is required by regulation. An Annual Development Plan must be written and a copy must then be sent to the local office of the Commission. DS0000062951.V366303.R01.S.doc Timescale for action 13/11/08 2. YA35 18 ( c ) (1) 13/11/08 3. YA36 18 (2) 13/11/08 4. YA39 24 (2) 13/11/08 Kemsing Road Respite Service Version 5.2 Page 28 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. 2. Refer to Standard YA7 YA9 Good Practice Recommendations It is recommended that the service train staff in the use of proper and descriptive recording methods. The risk assessment process should include common risks beyond the unique and individual risks that are currently recorded. It would be timely for the service to explore with those who visit Kemsing Road, and their relatives, the way in which activities are provided. It is recommended that the central log of complaints be recorded fully for ease of reference. It would be timely to now begin to think about a refurbishment programme, as some areas of decoration are looking worn. The carpeting on the ground floor should also be considered for replacement at some point in the not too distant future. Given the viewpoints expressed about the variable quality of service that is perceived by some relatives this should be explored further by the home and registered provider. 3. YA12 4. 5. YA22 YA24 6. YA39 Kemsing Road Respite Service DS0000062951.V366303.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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. 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