Care Home: Old Manse The

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What the care home does well The house is decorated to a high standard it is clean and homely. The people who live in the home have been together a while and have developed a good relationship with each other so the atmosphere is calm and supportive. Some of the staff have worked in this service a long time and have built up close relationships with people and support them to make decisions, choices and to live as independently as possible.People are supported to develop personally and several have jobs that they enjoy doing. Paperwork and records are up to date and well ordered; health and safety checks are in place that are properly carried out and recorded. What has improved since the last inspection? People have undertaken training and now take part in the interview process and are able to have an input into who cares for them. A clos-o-mat shower toilet has been installed to help people maintain their personal hygiene independently and the home have made sure that everyone have their new travel passes so that they can travel freely. What the care home could do better: The garden is a good size but the home finds it difficult to maintain, they are considering bringing in someone to help care for it. CARE HOME ADULTS 18-65 Old Manse The The Old Manse 243 Main Road Biggin Hill Kent TN16 3JY Lead Inspector Ann Wiseman Unannounced Inspection 28th May 2008 08:30 Old Manse The DS0000006970.V364706.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 Old Manse The DS0000006970.V364706.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. Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Manse The Address The Old Manse 243 Main Road Biggin Hill Kent TN16 3JY 01959 571695 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) pethrona.fray@care-ltd.co.uk www.care-ltd.co.uk CARE (Cottage and Rural Enterprises Ltd) Mrs. Pethrona Fray Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Old Manse The DS0000006970.V364706.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 (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 8 13th February 2007 Date of last inspection Brief Description of the Service: The Old Manse is a detached two-storey house situated in the High Street at Biggin Hill. It has been converted to meet its present purpose as a care home. Shops and public transport links are within easy walking distance. The home is registered to provide care for eight people who have a learning disability. The communal areas are on the ground floor and consist of a lounge, kitchen/diner and a utility room. There are also a bathroom, shower room and three bedrooms on the ground floor and each bedroom has a wash hand basin, and is wheelchair accessible. The first floor has five bedrooms with en suite facilities. All bedrooms have TV sockets and an alarm call system. There is a large garden, which is accessible via a ramp and there is a garage at the side of the house and off-street parking at the front. At the moment the home has a vacancy and there are only seven people living there. Old Manse The DS0000006970.V364706.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 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced inspection and we arrived at 8:30 while people were having breakfast and getting ready to go to their day centre. We were able to witness the manager administering medication and she remained at the home for the duration of the inspection to answer our questions and to produce the information we asked her for. The manager has sent us the Annual Quality Assurance Assessment (AQAA) she had completed. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the service. Before we visited we had sent surveys to the people in the home, their relatives and the staff. We got a very good response; everyone living there completed a survey, either by themselves or was helped by a staff member. Four relatives replied and six carers responded. Mainly people were positive about the service. We also talked to people as they got ready to go out and looked at two of their care plans. We inspected two staff personnel files and sampled some of the policies and procedures and the health and safety records, which were up to date and in order. Overall the home was found to be comfortable and able to meet the needs of those living there and people said they were happy in their home. The house was clean and tidy and the atmosphere was friendly and congenial, interaction between the staff and the people living in the home was friendly and open. Staff responded to people in a supportive and respectful manner. The program of redecoration and maintenance is ongoing and the house is well maintained. It’s style is contemporary with many attractive pictures on the walls, including some works done by people themselves that have been professionally framed. What the service does well: The house is decorated to a high standard it is clean and homely. The people who live in the home have been together a while and have developed a good relationship with each other so the atmosphere is calm and supportive. Some of the staff have worked in this service a long time and have built up close relationships with people and support them to make decisions, choices and to live as independently as possible. Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 6 People are supported to develop personally and several have jobs that they enjoy doing. Paperwork and records are up to date and well ordered; health and safety checks are in place that are properly carried out and recorded. 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. Old Manse The DS0000006970.V364706.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 Old Manse The DS0000006970.V364706.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): Standards 2 and 5 were examined on this occasion. People who use the service receive Good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Everyone has their needs and aspirations assessed prior to their moving into the house. People can test drive the home before they decide to move in permanently and once they have moved in they are given contracts. EVIDENCE: We examined the files of two people living in the home on this occasion and evidence was seen that their needs and aspirations were assessed and continue to be reviewed. The files also contained a service agreement that was signed by the person and their family members. The home has the required policy and procedure in place regarding taking in new people and the manager assured us that the required procedure would be followed when they fill the vacancy they have. The vacancy is longstanding and the manager acknowledged the importance of anyone new being supported to settle into the home as the present group has been together for a long time. Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 9 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): Key standards 6, 7, 8, 9 and 10 were judges during this visit. People who use the service receive Excellent quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Care plans are in place and are reviewed regularly. People are supported to make decisions about their lives and are allowed to take risks as part of an independent lifestyle. EVIDENCE: We looked at two people’s files in detail and found that the care plans were detailed and covered all aspects of their lives, there was evidence that everyone has their needs and aspirations reassessed each year at a review meeting. Since the last inspection person centred planning has been introduced. Annual meetings are held, the person concerned is central and their family and any professional involved are invited to attend. At the meeting objectives are set and timescales are agreed. Six monthly reviews are arranged when the progress is checked. Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 10 People are given opportunities to make decisions about their lives and day-today activities. Group discussions are encouraged on topics that will affect them all, including where to go for the annual holiday or planning special outings. We saw a discussion between two people who were planning an activity for that weekend. They both wanted to do different things, the pros and cons were put forward and a decision was made that both people were happy with. The house has user meetings regularly which are recorded and outcomes are actioned. We were able to see the notes and people have an opportunity to take part in the providers residents committee that meet regularly. They belong to a self-advocacy group and also have access to a drop in advocacy service where they are able to voice concerns or discuss personal topics. If they want to people can attend staff meetings and a representative of the people living in the home sits on interview panels so they can help chose their future carers. Risk assessments are done in many areas of people’s lives. The assessments on file were realistic and the interventions that are put in place enable people to take risks without restricting them unnecessarily. When we arrived the personal files were stored in the office in a locked filing cabinet and the manager assured us that when not in use they are always locked away and are not left out for others to read. Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 11 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): Standards 11, 12, 13, 14, 15, 16, and 17 were assessed during this inspection. People who use the service receive Good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People have the opportunity to take part in adult education and work. They take part in appropriate leisure activities and engage in the local community. They have regular contact with family and friends and are offered a varied and healthy diet. EVIDENCE: Files and records showed evidence that people attend adult education classes such as communication skills, computer club and words, numbers and discussion. Everyone living at the home attends a day centre and pick and chose what sessions they want to attend. Four people have part time jobs, some work in a charity shop and some participate in local rotary catering functions by serving food or helping in the kitchen. Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 12 People take part in the local community while shopping, eating out, going to the library and using public transport. Some people attend the local Church and Bible class’s independently. They arrange their own hair appointments and three people travel independently and will attend dental appointments alone. Family contact is supported and encouraged by the home and some of the people stay with their family for overnight and weekends. The manager told us that staff receive training in recognising peoples rights, she assured us that they understand the need to respect and uphold people’s rights and that they support people to take responsibility for respecting others rights as well as their own within the home. One family member told us that they would prefer it if their relative was supported to keep their bedroom tidier and cleaner. We discussed the issue with the manager, she said she was aware of the issue and that she and the staff were working with the person to develop their housekeeping skills. The fridge and freezer contained ample quantities of food and the menus we saw are written in consultation with people living in the home. They were varied and interesting. An alternative is always offered if preferred. Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 13 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): Standards 18, 19, 20 and 21 were judged on this occasion. People who use the service receive Good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Care Plans detail personal needs, including preferences. People are registered with their local GP and medication is managed efficiently. EVIDENCE: Care Plans clearly show support needs and note preferences in the way the people want to receive personal care. If someone is identified as needing extra help the home will make a case to the placing authorities to gain funding for extra hours to better support that person. The home has successfully asked for extra support in the past and recruited a staff member to work with someone on a 1-1 basis. Evidence was noted in people’s files that show they receive appropriate medical treatment; there are reports from doctors and records of hospital appointments. There were also reports from other health service professionals such as occupational health and psychology. The medication is stored in a cabinet that is kept locked and is secured to the wall. The medication and records were examined and showed no mistakes or omissions. Safeguards are in place so that some people can manage their own medication. Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 14 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): Key standards 22 and 23 were assessed during this visit. People who use the service receive Good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Complaint procedures are in place and required Protection of Vulnerable Adult Training is given. EVIDENCE: The records show that any complaints made have been investigated and the outcomes recorded, and their progress can be tracked in the homes complaints log. There have not been any new complaints since the last inspection, nor have we received any concerning this home. Records show that staff are expected to attend protection of vulnerable adult (POVA) training and are checked against the POVA list prior to them starting work. The homes recruitment process helps to protect the Service Users against abuse. Six staff members have responded to our survey and all of them confirm that these safeguarding checks were carried out when they were employed Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 15 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): Standards 24, 29 and 30 were assessed during this inspection. People who use the service receive Excellent quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The Old Manse has a homely aspect. It is comfortable and is kept clean and hygienic. Specialist equipment is obtained to maximise independence. EVIDENCE: The house is accessible, safe and well maintained and provides people with an environment that is relaxed. There is an abundance of personal items, photos and ornaments around the home, the furniture is attractive and comfortable and the decoration is in a modern, domestic style that the people living in the home have helped to choose. A clos-o-mat shower toilet has been installed to enable people to maximise independence during personal care. The home is kept clean and hygienic by staff with some input from the people living in the home who are supported to keep their rooms clean and tidy. Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 16 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): Standards 32, 34, 35 and 36 were assessed during this inspection. People who use the service receive Good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People at this home benefit from a staff team that is competent and effective, the homes recruitment policies and practices are in line with requirement. EVIDENCE: We viewed two staff files including training records. They reflected that the required recruitment practices were carried out. The home had several staff vacancies at the last inspection that affected the quality of care given but recent recruitment means that the house is fully staffed now. Staff who completed our survey said that they were given training that was relevant to their roles and that helped them understand and meet the individual needs of the people they care for. Training records indicate that the training offered is full and varied. It includes Health and Safety, First Aid, basic Food Hygiene, Person Centred Planning, Moving and Handling, personal Awareness, Medication and Protection of Vulnerable Adults. The files contained supervision notes and the manager and staff said that supervision was offered regularly. Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 17 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): Standards 37, 39, 40 and 42 were assessed during this visit. People who use the service receive Good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People benefit from a home that is well run and can be confident that their views underpin the running of the home. Health and Safety safeguards are in place and checks are carried out regularly. EVIDENCE: While we talked to the manager it became apparent that she is knowledgeable and fit to run the Old Manse, she shows a good understanding of the people in the home and their needs. It is our observation that the ethos of the house is geared toward empowering people to live an independent and fulfilling lifestyle. Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 18 The home is well organised and people benefit from the calm and supportive atmosphere generated by the manager and staff. In past discussions with the providers they have demonstrated themselves to be committed to offering a flexible and good quality service. A sample of Health and Safety records were sampled and found to be in order and information recorded in the AQAA tells us that policies and procedures are kept updated and are reviewed so that they reflect recent changes in legislation. The house gives annual surveys to people living in the home and their families, the information is collated and actions are planed for areas that are highlighted. All of the seven people living at the Old Manse returned our survey and none made any negative comments, during the visit people said they were happy, one person said, “I love it here, all my friends are here and I can go on holiday with them.” Another said, “I like the people here and the staff are nice.” One relative said in our survey, “Every aspect of the care at our relatives home is very good, we feel most fortunate that they are there” another relative commented, “We have been impressed by the support our relative has been given to develop and maintain their independence skills as far as possible.” When asked what they felt the home did well someone said, “They develop individual’s skills and abilities, they respond appropriately to behavioural changes and liaise well with families.” Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 19 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 X 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 4 25 X 26 X 27 X 28 X 29 4 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 4 3 LIFESTYLES Standard No Score 11 4 12 4 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 4 X 3 3 X 3 X Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 20 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 Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 21 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. Extracts may not be used or reproduced without the express permission of CSCI Old Manse The DS0000006970.V364706.R01.S.doc Version 5.2 Page 22 - 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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