Care Home: Kentmere Respite Service

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What the care home does well The short break service at Kentmere provides a personalised service for people. The surveys received indicated there are high levels of satisfaction with all aspects of the service. The comments received included: `I spend one weekend per month at Kentmere. I like the staff and I enjoy singing for them when I go. They help me if I need help.` `I started going for tea then worked up to an overnight stay and longer. I am assisted in everything and always included in activities.` `We consult and liaise well with parents/carers and people using the service and give a varied choice of activities and personalised service to individuals.` The written information explaining the care service that is offered has been made easily accessible by the use of pictures and simple language, and this helps people to gain an understanding of daily life at Kentmere and the people who work there. The staff work in partnership with parents, carers and professionals involved in providing supports for the person both at home, at day placements and school. This promotes consistency in the way a person is supported and makes sure their personal preferences and choices are understood. The care plans highlight what is important to the person. The ways in which people who use the service comminicate are understood and followed by staff.The importance of promoting independence and balancing personal choice with risks to health and safety is appreciated by the staff of Kentmere. Risk assessments are completed for the areas that are identified during the initial assessment and care planning process. The staff consult with people who use the service, parent/carers and social workers to ensure they have all relevant information to provide a personalised quality service which respects cultural and lifestyle choices. There have been no formal complaints received by Kentmere or the commission during the past 12 months. There are good arrangements in place for handling complaints. The complaints procedure is available in an easy read format. The service is proactive in seeking views of the people who use it and their representatives. Kentmere has a well established staff group who work well together as a team and aim to provide a quality service to the people they support. The staff have the knowledge, skills and abilities to support the people who come for short breaks. Comments from staff included: `I feel that being a person centred service has been a great improvement. Its about acting on what is important to a person from their own perspective and our role is to ensure that we work with the person, we support, to achieve the outcomes and expectations they want from accessing short breaks.` `I enjoy my work. I find it rewarding and feel we all work well as a staff `team`. Staff and managers always try hard to meet individual needs.` The manager of Kentmere has extensive experience and is qualified. She is regarded as approachable, supportive and committed to involving people who use the service and the staff in the future development of the short break service. The manager provides clear direction and leadership. The people using the service are regularly asked their views. They are also involved together with the staff group in contributing to the planning of future services. What has improved since the last inspection? The expansion of the service to include people of 16 years has provided an excellent opportunity to support people as they make the move from services which support children to adult services.The manager has developed an Emergency Protocol which gives staff advice about how to gather important information about the care needs of the person. This has been of great value when supporting families in crisis. The staff have introduced care plans in easy read and picture formats which are meaningful to some of the people who use the service. These plans are the property of the person using the service. There has been adaptation to the property, including the fitting of overhead tracking system in the bathroom and assited bathing facilities, which ensures that people are supported safely whilst using the service. The bedrooms are individually decorated and one of the rooms has been redecorated to appeal to younger people who come to the house for a short stay. The management structure of the service has been reviewed resulting in the appointment of two part time relief officers to support the manager within her role across the district in providing a consistent approach and day to day management of the service. What the care home could do better: The service continues to look at how it can improve further and there were no areas of concern found at this inspection. CARE HOME ADULTS 18-65 Kentmere Respite Service 72 St Annes Road East Lytham St Annes Lancashire FY8 1UX Lead Inspector Mrs Felicity Lacey Unannounced Inspection 10th February 2009 2:00 Kentmere Respite Service DS0000035974.V374176.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 Kentmere Respite Service DS0000035974.V374176.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. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kentmere Respite Service Address 72 St Annes Road East Lytham St Annes Lancashire FY8 1UX 01253 727212 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) Lancashire County Council Mrs Elaine Jackson Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category 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: Learning disability - Code LD The maximum number of service users who can be accommodated is: 5 Date of last inspection 20th February 2007 Brief Description of the Service: Kentmere is owned by Lancashire County Council and is operated by Lancashire County Council Social Services. It is registered with the Commission for Social Care Inspection (CSCI) to provide personal care for five people who have a learning disability. Kentmere aims to provide a quality service for people using the short break service. Most stays are planned but the service does have provision for emergency admissions. Kentmere is situated in a residential area of St Anne’s with easy access to local shops, amenities and public transport. The property is a dormer bungalow with all resident’s rooms on the ground floor with full wheelchair access. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means that the people who use this service experience excellent quality outcomes. This inspection included an unannounced visit to the service. Information was provided before the visit by the manager of the home including the way in which the staff of the home meet the needs of the people using the service, the training and support staff receive and data about health and safety at the home. Surveys were received from two people who use the service and five staff members. At the time of the visit two people were staying at Kentmere. The manager and staff were spoken with. Case records and documents relating to the support provided at the service were looked at. A tour of the premises took place. Information about the service provided at the home has been collected since the last key inspection. What the service does well: The short break service at Kentmere provides a personalised service for people. The surveys received indicated there are high levels of satisfaction with all aspects of the service. The comments received included: ‘I spend one weekend per month at Kentmere. I like the staff and I enjoy singing for them when I go. They help me if I need help.’ ‘I started going for tea then worked up to an overnight stay and longer. I am assisted in everything and always included in activities.’ ‘We consult and liaise well with parents/carers and people using the service and give a varied choice of activities and personalised service to individuals.’ The written information explaining the care service that is offered has been made easily accessible by the use of pictures and simple language, and this helps people to gain an understanding of daily life at Kentmere and the people who work there. The staff work in partnership with parents, carers and professionals involved in providing supports for the person both at home, at day placements and school. This promotes consistency in the way a person is supported and makes sure their personal preferences and choices are understood. The care plans highlight what is important to the person. The ways in which people who use the service comminicate are understood and followed by staff. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 6 The importance of promoting independence and balancing personal choice with risks to health and safety is appreciated by the staff of Kentmere. Risk assessments are completed for the areas that are identified during the initial assessment and care planning process. The staff consult with people who use the service, parent/carers and social workers to ensure they have all relevant information to provide a personalised quality service which respects cultural and lifestyle choices. There have been no formal complaints received by Kentmere or the commission during the past 12 months. There are good arrangements in place for handling complaints. The complaints procedure is available in an easy read format. The service is proactive in seeking views of the people who use it and their representatives. Kentmere has a well established staff group who work well together as a team and aim to provide a quality service to the people they support. The staff have the knowledge, skills and abilities to support the people who come for short breaks. Comments from staff included: ‘I feel that being a person centred service has been a great improvement. Its about acting on what is important to a person from their own perspective and our role is to ensure that we work with the person, we support, to achieve the outcomes and expectations they want from accessing short breaks.’ ‘I enjoy my work. I find it rewarding and feel we all work well as a staff ‘team’. Staff and managers always try hard to meet individual needs.’ The manager of Kentmere has extensive experience and is qualified. She is regarded as approachable, supportive and committed to involving people who use the service and the staff in the future development of the short break service. The manager provides clear direction and leadership. The people using the service are regularly asked their views. They are also involved together with the staff group in contributing to the planning of future services. What has improved since the last inspection? The expansion of the service to include people of 16 years has provided an excellent opportunity to support people as they make the move from services which support children to adult services. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 7 The manager has developed an Emergency Protocol which gives staff advice about how to gather important information about the care needs of the person. This has been of great value when supporting families in crisis. The staff have introduced care plans in easy read and picture formats which are meaningful to some of the people who use the service. These plans are the property of the person using the service. There has been adaptation to the property, including the fitting of overhead tracking system in the bathroom and assited bathing facilities, which ensures that people are supported safely whilst using the service. The bedrooms are individually decorated and one of the rooms has been redecorated to appeal to younger people who come to the house for a short stay. The management structure of the service has been reviewed resulting in the appointment of two part time relief officers to support the manager within her role across the district in providing a consistent approach and day to day management of the service. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 Quality in this outcome area is excellent. Detailed assessments and care plans make sure peoples needs and personal aspirations are assessed and responded to appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is written information explaining the care service that is offered, the management and staff arrangements and what the person using the service can expect if he or she decides to stay at the home. This information has been made easily accessible by the use of pictures and simple language, and this helps people to gain an understanding of daily life at Kentmere and the people who work there. There were good examples showing that staff work in partnership with parents, carers and professionals involved in providing supports for the person both at home, at day placements and school. The assessments seen were thorough and included the views and aspirations of the person using the short break service. Staff spoken with had a good understanding of the needs of the people they support. The period of assessment is flexible, the person who is to use the service is encouraged to be part of the assessment and planning process. The aim of the short break service is to meet a persons support needs in a consistent way and in the prefered way of the person staying at the service. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 10 The expansion of the service to include people of 16 years has provided a excellent opportunity for people to be supported as they move from services that support children to adult services. A flexible and planned introduction into the service helps people to become familiar with the enviromnent and build up trust and relationships with the staff team. The information provided by the manager of Kentmere states ‘The relationships with families and carers is a high priority and the staff team are actively encouraged to make these links and keep the families informed both verbally and in writing of all aspects of their relatives stay.’ Discussion with staff confirmed that they are active in speaking and meeting with families and carers on a regular basis and in this way built up good relationships and communication. Most people are able to plan when they intend to stay at Kentmere, but on occasion an emergency may arise which means someone is admitted to the home, with out the time to become familiar with the service. In these cases the manager has developed an emergency protocol which gives staff advice about how to gather important information about the care needs of the person. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 11 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): 6, 7, 9 Quality in this outcome area is excellent. Care planning systems have been developed that make sure staff can meet peoples assessed and changing needs and their personal choices and dignity are respected at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care planning system in place is thorough and covers all areas of personal and health care support. The staff have completed training in ‘Person Centred Approaches’ and this is reflected in the care plans seen. Each persons care plan begins with a section which celebrates the likeable and positive qualities of the person, it then goes on to consider their preferences, and also includes the persons views and hopes for the future. The care plans highlight what is important to the person. The staff have also introduced care plans in easy read and picture formats which are meaningful to some of the people who use the service. These plans are the property of the person using the service. The plans are kept in the Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 12 persons room when they come and stay and are updated with photos and memories of activities and events they have taken part in. This provides a interesting record of what a person has done and also gives the opportunity for the person to share their experiences with carers and friends. Some of the people who come to Kentmere have limited verbal communication skills. Staff work with the person and their carers to build up an understanding of the communication used, this can be through using pictures, sign languauge or facial expressions. The staff have benefited from training and support from speech therapy services and other professionals: for instance one person has a communication picture system which is used at school and staff went to the school to learn how to put this system in place when the person visits Kentmere. During the visit to the home a person was being supported by a Community Support Worker with British Sign Language certificate in communication provided by the Royal National Institute for the Deaf, this support was very important in helping the person staying at the service express herself. Some staff are trained in the use of sign language, and other staff are supported by guidance about finger spelling and important signs that this person uses. In this way the staff are making excellent efforts to support people who may have limited communication to make choices and direct their own care. The importance of promoting independence and balancing personal choice with risks to health and safety is appreciated by the staff of Kentmere. Risk assessments are completed for the areas that are identified during the initial assessment and care planning process. There was evidence seen of staff being involved in risk management meetings at which strategies are discussed and decided upon, this involvement promotes a consistent way of managing risk across all the settings a person may use. The support needs of the people who use the service vary considerably and the level and type of risk assessment undertaken reflects this. For exmaple there are some people with complex physical needs and learning disabilities and the risks they face are quite different to people who display challenging behaviour. The staff spoken with were aware of the identified risks and the guidance for how to support people in maintaining their independence, respecting their privacy and dignity and right to make choices. The manager explained that the compatibilty of people staying at Kentmere is borne in mind and this includes consideration of risk factors, when planning a short break. There was evidence that risk assessments are regularly reviewed to make sure they are still useful. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. The activities and opportunities offered at Kentmere are designed to meet the needs of the person having a short stay, in this way personal expectations and lifestyle choices are respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The needs and wishes of the people supported at the service are respected and their lifestyle choices are promoted at Kentmere. Some people stay for a very short time and others come for longer periods. The staff consult with people prior to their stay to ask if there is any particular activity they would like to do whilst staying. There is a flexible booking system to allow friends to book dates together and maintain friendships. The staff are proactive in making sure that the persons individual routines and occupations such as attendence at Day Services, College, employment, hobbies and social activities are carried on with whilst the person is staying at Kentmere. The service responds well in a crisis and will accommodate service users in an emergency situation, working with other support services to try and reduce the Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 14 upheaval and disruption experienced by the person, this is particularly important in times of family crisis. There is a range of community based activities on offer. The staff have compiled a ‘Whats on Guide’ to help people make the most of their stay. Some people are supported by staff to follow their particular interests, for example one person is very fond of trains and has enjoyed spending time travelling by train and is planning to visit a transport museum at a future stay. The staff consult with people who use the service, parent/carers and social workers to ensure they have all relevant information to provide a personalised quality service which respects cultural and lifestyle choices. One way in which this is done is by ensuring staffing levels are appropriate to support people who wish to attend places of worship. Kentmere provides a range of healthy eating options and staff involve people who are staying in choosing foods. This has been helped by a pictorial menu book, which contains photos and packaging of a range of popular foods. Support with specialist diets can be provided and the staff would work closely with anyone who needed a particular diet to make sure that it could be provided during their stay. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. Personal and healthcare needs are well documented with staff providing support to make sure individual physical and health needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The personal and health care needs of the people supported at Kentmere are well documented. The staff have liaised with parents, carers and other professionals to make sure that health care needs are fully understood, for example the Community Learning Disability Nurse offers giuidance and advice. There are comprehensive care plans and profiles which are completed in consultation with people using the service and parent/carers. These give clear guidance for the best way to support people so that staff assist in a manner that meets individual needs and choices. These plans are reviewed every six months and staff liaise with the person using the service and their parent /carers prior to their stay to ensure they have up to date information on any specific health needs. There are agreed protocols in place for specific health needs and staff have training to follow these, for example there is regular training available for the Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 16 administration of Rectal Diazepam, this can be attended by new staff and any staff member who wishes to refresh their skills. People using the service have their own aids and equipment for maximum independence and these are brougth along to the short break service. There has been adaptation to the property, for example the fitting of over head tracking system in the bathroom, to enable people to be supported safety whilst using the service. Each person has a designated Link Worker. This is a person who oversees the care planning and review of needs. This person will also act as a liason for parents and carers. As a short break service involvement with management of on going medical and health conditions is limited, however at times staff support people to attend a GP or hospital appointment. If this is required the staff will report any outcome and treatment recommended to the parent or carer. People are supported in line with the services policy about the administration medication and the persons own wishes. The storage arrangements seen were satifactory. Medicines are accounted for and recorded by two members of staff when a person comes to the service and when they leave. There was evidence of consultation about and consideration of peoples best interests when administering medication. The arrangements in place for medication were clearly documented and agreed as part of the care plan. All staff are trained in relation to health related tasks and have completed training about the safe administration of medication. The records seen at the time of the visit were completed correctly. Discussion with staff members confirmed they had received training and they were seen to be following the medication policy during the visit to Kentmere. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. The arrangements for gathering people’s views of Kentmere are good and people are confident their views are listened to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no formal complaints received by Kentmere or the commission during the past 12 months. There are good arrangements in place for handling complaints and staff were able to explain how they would deal with any concerns that may arise. The complaints procedure is available in an easy read format. People who completed surveys confirmed that they were aware of how to make a complaint and that they were confident any concerns would be acted upon. The service is proactive in seeking views of the people who use it and their representatives. There are phone calls made before and after people have been for a short break to make sure that the person was satisfied and to identify any concerns. People are also given Compliment/ Complaints and Concern slips after each visit. The complaints procedure is clearly displayed and gives advice about what to do if a person is unhappy during their stay as well as after they leave. The staff team are stable and know the people who use the service well, this benefits people who use the service, especially those who may show they are unhappy through their behaviour and gestures. Parents and carers are actively encouraged to drop in” for an informal chat and to discuss any issues around the care provided by the staff team. The Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 18 registered manager and the team are proactive in promoting this open door policy in order to build on the good relationships built up with parents and carers. The staff team have a good knowledge and understanding of safeguarding adult issues which protect people from abuse. The registered manager has recently attended Safeguarding Adult Investigation training. There are systems in place for recording of monies and receipts are provided for people who require assistance with personal money. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. The people who stay at Kentmere have a comfortable, safe and homely environment, which is also designed to meet the needs of people who are less mobile. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The house was clean and warm at the time of the visit. All bedrooms are on the ground floor making them easily accessible. The house has four bedrooms for use by people staying over. There is a kitchen diner and a large lounge. To the rear of the property there is an enclosed garden area. The bedrooms are individually decorated and one of the rooms has been redecorated to appeal to younger people who come to the house for a short stay. The people staying at Kentmere are encouraged to make a choice of the bedroom they wish to stay in, the information provided by the manager indicates that this works well and the staff try their utmost to accommodate individuals with the bedrooms of their choice for each and every stay. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 20 The bathroom has been refurbished and is now fitted with an overhead tracking system to enable the safe assistance of people with mobility difficulties. There is an assisted bath and this provides the opportunity for people who have specialist needs to access the short break service at Kentmere. Seven staff members have completed infection control training. There are systems in place to make sure the house is kept clean and hygenic. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. A settled, competent and well trained staff team provide a personalised package of support to the people using the short break service at Kentmere. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The surveys completed by people who use the short break service indicated that staff always treated people well and were responsive. Kentmere has a well established staff group who work well together as a team and aim to provide a quality service to the people they support. The staff spoken with felt supported in their roles, and had the knowledge, skills and abilities to support the people who come for short breaks. Staff spoken with were clear about their job roles. One staff member commented ‘I enjoy my work. I find it rewarding and feel we all work well as a staff ‘team’. Staff and managers always try hard to meet individual needs.’ Staff work in partnership with other professionals to meet the individual needs of people using the service, for example staff have worked with the speech therapy service to develop an inclusive communication tool. Staff have also developed good relationships with local schools as the service now provides short breaks to young people from 16 years old. Staff members act as Link Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 22 Workers and this involves ensuring the person who is using the short break service is supported in line with their needs and preferences, liaising with parents and carers and updating the persons support plan. The recruitment records seen demonstrated that the required references and Criminal Record Bureau checks were completed prior to a person beginning work at Kentmere. The manager is looking at ways of involving people who use the short break service in the recruitment process. All new and existing members of staff have completed the induction and foundation training which has been developed for staff who support people with a learning disability. Staff have also attended Person Centred Approach training. One member of staff commented ‘I feel that being a person centred service has been a great improvement. Its about acting on what is important to a person from their own perspective and our role is to ensure that we work with the person, we support, to achieve the outcomes and expectations they want from accessing short breaks.’ Four staff have completed a National Vocational Qualification at level 2 or above, this is the recommended qualification for people working in social care. Staff spoken with during the visit and who completed surveys felt that training was encouraged and available. The needs of the people staying at Kentmere are understood and this is helped by regular training opportunities. One staff member commented ‘ I am able to discuss with my manager and with my colleagues, at team meetings, training that I have been on and pass the information and knowledge on. Training is encouraged to develop our skills. We can also inform the manager of our interests regarding training and she will actively try to ensure we are put forward to attend relevant training.’ Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is excellent. Kentmere is a well run service and there is regular consultation with people which means that people using the service contribute to its development. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of Kentmere has extensive experience and is qualified. She is seen as approachable, supportive and committed to involving people who use the service and the staff in the future development of the short break service. The manager provides clear direction and leadership. A staff member commented ‘ I feel that as a service we, the staff, have a manager that is approachable, has integrity, is a good listener and informs the staff regularly of new things that are happening. The staff feel involved in decisions.’ This view was supported by other staff who took part in the inspection. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 24 The management structure of the service has been reviewed resulting in the appointment of two part time relief officers to support the manager within her role across the district in providing a consistent approach and day to day management of the service. The service is part of a wider District Service which aims to promote a consistent approach for staff teams supporting people with a learning disability, through sharing information and good practice and this creates an open, positive and inclusive atmosphere. Kentmere is represented on the Local Learning Disability Partnership Board and has a well-established relationship with the Fylde and Wyre Parents/Carers Forum, which is pro-active in the continued development of the services offered. The satisfaction of people using the service is monitored in a number of ways. After each stay a contact is made afterwards to make sure that the person had been happy and to identify any issues or improvement that could be made. Comments/Compliments and Complaints slips are available and people are encouraged to complete these. There are regular reviews of the service and people are supported to make their views known. The people who use this service and the staff who were involved in this inspection were satisfied with the service provided, and felt that their opinions were valued. The service is regularly visited by a senior manager from the County Council, and these visit include the monitoring of quality and include discussions with people using the service and staff. The health and safety of the people using service is protected by policies and procedures and recent internal and external health and safety audits have been undertaken. Staff are trained in health and safety topics, for example all staff have received training in the safe use of the specialist equipment recently installed in the bathroom. Risk assessments are in place and are regularly reviewed. All accidents and incidents are recorded, and these are monitored by the manager to identify any hazards and trends. Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 25 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 4 3 X 4 4 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 4 X X 3 X Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lancashire Aera Office 2nd Floor, Unit 1 Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kentmere Respite Service DS0000035974.V374176.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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