Care Home: Neptune House

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What the care home does well The service meets the needs of the Service Users living at the home in such a way that allows Service Users to improve their individual living skills, take responsibility of choice, increase their knowledge, confidence and self esteem. What has improved since the last inspection? The home has continued to maintain the high standards from the last inspection where their were no Requirements or Recommendations. What the care home could do better: To continue with the high standards that are already in place. CARE HOME ADULTS 18-65 Neptune House 8-10 Neptune Terrace Sheerness Kent ME12 2AW Lead Inspector Graham Cummings Key Unannounced Inspection 3rd April 2007 09:30 Neptune House DS0000023983.V330507.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 Neptune House DS0000023983.V330507.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. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Neptune House Address 8-10 Neptune Terrace Sheerness Kent ME12 2AW 01795 581660 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) Neptune House Limited Miss Vivian Cumber Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That room one (1) must always be used by someone without mobility problems. 17th January 2006 Date of last inspection Brief Description of the Service: The home occupies Grade 2 listed premises in the centre of Sheerness, overlooking the Thames estuary from the rear. There are no immediate parking facilities, but easy access to nearby side street parking. Public transport is within a short walking distance, as are all local amenities. There is a small paved area to the front of the property, leading to the main entrance, while access to the pleasant rear garden is from the lower ground floor. accommodation is on three floors, including the lower ground floor, with bedrooms being on the ground and first floors. There is spiral staircase access between the ground and lower ground floors. There is a fire exit on each floor. The home is attractively furnished and decorated to a good domestic standard and presents a warm and welcoming aspect. The home has now completed the extension into number 8 Neptune and the Registration has increased from 10 to 14 Service Users. The fees range from £729 t0 £995 per week. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first Key Inspection under Inspecting for Better Lives and consisted of looking at past reports, speaking to Service Users, staff, Manager, viewing documentation and touring the home. The Inspector sat with six Service Users, most who had remembered me from my previous visits and all were pleased to tell me that the home is ‘still the best ever’ ‘very good’ ‘staff are brilliant, helpful and friendly’ ‘ I can do what I want when I want’. Service Users were aware of their responsibilities and activities for the morning, several were on Easter breaks from their college courses but they had made a choice of an activity they would like to do until coffee break at 11am. The home is relaxed and welcoming with Service Users able to discuss and choose activity options and outings. The next Service User meeting was being looked forward to as they were going to be choosing their holidays for this year. The Manager and staff showed excellent skill in making sure that it is the Service Users that are taking responsibilities for making the choices in their daily lives. Staff when asked questions were reflecting them back to the Service User with ‘What would you like..’ ‘is that what you want’ ‘if that’s what you want’. At coffee break it was good to hear a lot of talking, laughter and discussion between Service Users with staff joining in as part of the group and not leading the conversation. The Manager has been very aware that the vacancies that have arisen due to the purchase of next door are filled with Service Users that could adapt, fit and enhance the lifestyle that present Service Users have created. This has made it difficult to fill the vacancies despite a number of referrals, the Manager is insistent that any placement filled has to be the right one and in agreement with current Service Users. The care plans and all documentation is of a high standard that is signed, dated and regularly reviewed. Activities since July 2006 have included Santus circus, Port Lympe, pictures, Beefeater pub for meal, Billy Smarts circus, firework display, theatre, pantomime and a trip to the local fire station. It is clear that the home is run in the best interests of the Service Users. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? 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. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are able to make an informed choice about moving to the home. Each Service User has an individual written contract with the home. EVIDENCE: The referral for the latest admission was made on the 3/7/06, the Manager was asked to admit as soon as possible, the Manager was not prepared to make the decision until they were sure that the placement would benefit the new Service User and not disrupt current Service Users at the home. The Inspector looked at the file of the last Service User to move into the home, this showed that they were fully involved in the process along with their family and care manager. The Manager had documented each telephone conversation and visit made to the home over a three week transition program that included trips out with staff and Service Users, visits to the home for meals and activities as well as two overnight stays before moving into the home permanently on the 24/07/06. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 9 The Statement of Purpose had been updated and files contained contracts. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service Users needs are assessed and their changing needs reflected in an individual plan. They are consulted and supported to take risks and make decisions in their daily life. EVIDENCE: The Inspector looked at the care plan for the latest admission and found it to be well written in plain English and comprehensive. The details of improving the individuals living skills were clearly broken down into small achievable tasks that would raise confidence and self-esteem. The plan contained likes and dislikes, risk assessments, weekly timetable that included arts and craft, skills room, keep-fit and relaxation, computer literacy, home domestics, ready steady cook, fun time hobbies, music and movement, out and about swimming, cinema and bowls. The file also had Service User Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 11 consent forms relating to visitors, medication and religious beliefs, there was also a fire training attendance certificate on file. The day notes were clearly written and contained detailed information on what the Service User had done during the day and if they had achieved any new skills. Service Users told the Inspector they are fully involved in the making of their care plan and where they were kept if they wanted to look at them, those seen were also signed by the Service User. The Inspector saw evidence that the care plans were evaluated at six monthly intervals, previous copies seen were also signed indicating that this was normal practice. Service Users were fully aware of the Inspectors role and were happy to talk and discuss life at Neptune House and the positive outcomes it had given them. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users have the opportunity for personal development and take part in age appropriate leisure activities. Service Users have their rights respected, are part of the local community and have could family contact. Service Users receive a nutritious and wholesome diet in pleasant surroundings. EVIDENCE: Each Service User has a wide range of choices in their individual program this included arts and craft, skills room, keep-fit and relaxation, computer literacy, Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 13 home domestics, ready steady cook, fun time hobbies, music and movement, out and about swimming, cinema and bowls. Some Service Users attend local colleges and are signed up on Independent living skills courses and spend time at home helping with the preparation and cooking of meals. Service Users are able to attend the fire training carried out in the home and receive certificates along with the staff. Service Users go out for walks along the beach and stop off at a local pub for a drink and meal, the local shops are used frequently by Service Users. Several of the Service Users have ‘boyfriends’ from outside of the home that they met whilst attending the local college, or special ‘disco’s’. They visit on a regular basis for meals and join in activities that the home have arranged. Comments from Service Users include ‘I can go to my room and be myself if I want’ ‘my boyfriend comes to visit me and stays for lunch’. The Inspector observed a positive interaction between staff and Service Users who were treated with dignity and respect. The Manager and staff showed excellent skill in making sure that it is the Service Users that are taking responsibilities for making the choices in their daily lives. Staff when asked questions were reflecting them back to the Service User with ‘What would you like..’ ‘is that what you want’ ‘if that’s what you want’. Staff knock on Service User bedroom doors prior to entering. Family members and friends are encouraged to visit at any reasonable time and participate in activities and outings that have been arranged for that day. The menu seen was varied and Service Users spoken to said ‘the food is good’ ‘we help to prepare and cook food’ ‘if I don’t like it I can have something else’. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users receive personal support in the way they prefer and have their health needs met. One Resident self medicates and the home has policies and procedures in place to protect the Resident. EVIDENCE: All of the Service Users are registered with a local GP, Dentist and Optician, a Chiropodist visits on a regular basis. The home has a separate medical file for individual Service User that contains a list of all the medication and details of possible side effects, the times medication should be given, allergies and GP’s name and telephone number. Other information includes, general medical notes, weight chart, GP visits and outcomes, Dentist visits and outcomes and Optician visits and outcomes. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 15 Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are listened to and they are protected from abuse. EVIDENCE: Service Users views are listened to and acted upon by the staff and Manager wherever possible. The home have regular Service User meetings and the Manager has an open door policy where Service Users and staff can come and speak to them. The home also has a key-worker system in place where an individual staff member takes a lead role in making sure that the needs of the individual are met. Staff have received Protection of Vulnerable Adults and NAPPI training, also part of the homes Induction program is to read the Policies and Procedures on Abuse which they sign to agree that they have read and understood the policy. Service Users are able to attend the fire training carried out in the home and receive certificates along with the staff. The Commission have not received any complaints about the care provided at the home since the last inspection. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 17 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. This judgement has been made using available evidence including a visit to this service. Service Users live in a comfortable clean and safe environment. EVIDENCE: The home is clean and spacious with space well utilised to give Service Users smaller areas to sit and listen to music or watch television away from the main group. The Inspector did not look at Service Users rooms as they were looked at during the last inspection. Service Users spoken to said that they helped clean their rooms and they had televisions and stereos. All of the Service Users spoken to said they were happy with their bedrooms. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 18 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): 31,32,34,35,36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service Users are supported by a competent staff team and benefit from a robust recruitment practice. Service Users benefit from a staff team that understand their roles and responsibilities and who are well supported, supervised. EVIDENCE: A staff member spoken to confirmed that they had a job description that they had signed to say they understood their role within the home, they also confirmed that they had monthly staff meetings and a minimum of 6 supervisions per year. The staff member in discussion said that all staff have to read the policies and sign them to say they have understood them, this is done during the induction period and a different policy discussed at staff meetings. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 19 The Inspector looked at the file for the staff member spoken to and found that it contained all details required in Schedule 2 of the Care Home Regulations 2001. A signed job description and supervision notes were also seen. They had been appointed in November 2006 and had received training in Moving and Handling, 1st Aid, Food Hygiene, Medication, Health and Safety, Fire, NAPPI and POVA. Comments from the staff member included, ‘the home is so well organised that I spend a lot of time being with Service Users, I was never able to do this at previous homes, it’s great here’ ‘I look forward to coming to work, the staff team and management are very supportive and friendly’. Staff were observed interacting with Service Users in a way that they retained choice and dignity and was very positive. Staff when asked questions were reflecting back to the Service User with ‘What would you like..’ ‘is that what you want’ ‘if that’s what you want’. Comments from Service Users included ‘I am able to do what I want and staff help me if I need it’ ‘staff are excellent and helpful’ ‘they are nice and friendly’. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 20 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): 37,39,41,42,43 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service Users live in a home that is safe and well run, benefit from competent management where their views are listened to and acted upon. EVIDENCE: The home has in the last year purchased the house next door and increased the occupancy level from 10 to 14. This has been completed and two of the rooms occupied. The Manager has had numerous enquiries to fill the vacancies but has declined most referrals as they were likely to disrupt or have a negative effect on the current Service Users lifestyle. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 21 During discussions with the Manager it was apparent that they were passionate about the Service Users living at the home being able to live a life they wanted and the home should enable them to make choices and decisions for themselves in a safe and secure environment. The Manager said they had ‘excellent support from the Administrator and staff’ in achieving this. The Administrator has devised systems that make sure that all of the Policies and Procedures, care plans, training matrix, supervisions are up to date and evaluated and signed and dated. They also have a checklist on the recruitment procedures and inductions of new staff to make sure that everything has been covered to protect Service Users. Weekly Health and Safety and Fire alarm checks are carried out and recorded. Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 22 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 3 5 3 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 4 32 3 33 X 34 4 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 X 3 X 4 4 4 Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Neptune House DS0000023983.V330507.R01.S.doc Version 5.2 Page 25 - 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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