Care Home: The Hadlows

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Hadlows 128 - 130 Hadlow Road Tonbridge Kent TN9 1PA two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Mills Date: 2 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: The Hadlows 128 - 130 Hadlow Road Tonbridge Kent TN9 1PA 01732355646 01732359527 hadlows@ilg.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Evesleigh (Kent) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 10 Number of places (if applicable): Under 65 Over 65 10 0 physical disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical disability (PD). The maximum number of service users to be accommodated is 10. Date of last inspection 2 7 1 1 2 0 0 7 A bit about the care home 128 and 130 Hadlow Road comprises of two houses, one of which is an end terrace property with the second adjoining. It is registered for ten people who have a diagnosis of acquired brain injury and offers all single rooms; five rooms in each house. Facilities are in both houses and accommodation is spread over three floors. The homes are not suitable for people with significant mobility difficulties as there is no lift between floors. The two communal lounges are located on the first floor along with two bedrooms and bathroom/WC. The second floor has the staff office/ sleep in room and one further bedroom and bathroom facility. There are two bedrooms and a walk-in shower facility/WC on the ground floor with access to a linked walk through dining room. Small kitchen and laundry area. There is no separate visitors room or communal space located on the ground floor. The home is located approximately a mile from the centre of Tonbridge where there are all the facilities of a town including shops, eating places, pubs, churches, a Post Office and banks. The nearest main line station is approximately two miles away and the nearest bus stop fifty yards away. The home has limited car parking facilities to the front of the building and on street parking to the side of the property. There is a garden to the rear of each house, which service users are able to use. The fees range between £1100 and £1200 per week and are based on an assessment of need for each service user. A copy of the last inspection report is available at the home. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home This visit formed part of the inspection process of the Commission for Social Care Inspection (CSCI) under the Care Standards Act 2000.This report is compiled using evidence gathered during this visit and information that we have received prior to the visit. This includes information that the home has sent us such as their Annual Quality assurance Assessment (AQAA) and notifications about any significant events occurring in the service. This information is required under the Act. The views of the people who use this service and staff have also been taken into account when compiling this report. The outcome of this inspection will lead to the home being given a star quality rating. During this visit four service users and three staff were spoken in private to seek their views about the home. Documentation, including care plans, staff files and the medication administration record (MAR), was examined and a tour of the home was made. Case tracking, based on three service users was carried out. This means that the care and support given to three residents, picked at random, was examined in detail. The care plans were checked against the views of the service users and other records held in the home such as the daily record, notes of service user meetings and care reviews. Direct and indirect observations were made throughout the duration of the visit and detailed discussion was held with the registered manager. The quality rating for this service is 2 Stars. This means that the home is judged to be good. What the care home does well What has got better from the last inspection The home has a new manager and this has improved the way the home is managed in a number of ways, from listening to the views of service users and staff, to staff retention. There have been significant environmental improvements including new kitchens, redecoration and refurbishment of the lounges and improvements in the garden area. The way medicines are managed and administered has improved. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Wendy Mills CSCI The Oast Hermitage Court Hermitage Lane Barming Maidstone ME16 9NT 01622 724950 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home gives prospective service users and their supporters the information they need so that they can make an informed decision about moving into the home. There are sound policies and procedures in place to ensure prospective service users are properly assessed prior to being offered a place in the home. Evidence: There is plenty of information for the people who use this service. There are folders in each house containing information about how to complain, what to expect from the service and other useful information. In addition there are notice boards with additional information about activities and local facilities. No new service users have been admitted to the home since the last inspection but there are clear policies and procedures in place to ensure that any prospective service users are properly assessed prior to admission so that the home is sure that their needs can be met and that they will fit into the life of the home. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home supports the people who use the service to make informed choices and decisions and to take appropriate risks. Evidence: There is good evidence that the home values equality and diversity. Care planing is person centred and the written care plans reflect the differing needs of each individual. There are regular care planning meetings where realistic goals are agreed and recorded. Staff said that they support the people who use the service to make informed decisions and to try to consider different options. The service users said that they are involved as much as they want to be in the care planning process and the day to day running of the home. There are regular house meetings and the manager has an open door policy. Service users said that they can discuss any ideas or wishes with him whenever they want. The manager said that he is currently trying to arrange for an advocate for one service user to help him express himself more easily. Information about the service users is stored securely and staff understand the need for confidentiality. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home encourages the people who use this service to spend time participating in meaningful activities. This promotes their independence. Evidence: There is a wide rage of activities available to the service users, both within and outside of the home. Some service users have part time jobs whilst others attend centres where they can take part in things that especially interest them. On the day of this visit one service user was out shopping and another was taking part in a cookery class. Records show that there has been an increase in the choice of activities since the last inspection. There is good care planning and goal setting. The care plans record the equality and diversity needs of the individual. The people who use this service said that they are fully involved in their care planning. They said that they can choose how they spend their time. Some service users said that they enjoy helping out around the home. Some are more reluctant but still recognise the need to ensure their rooms are kept clean and tidy. The kitchens in both houses have recently been refitted. The fridges and freezers were well stocked on the day of this visit. There was plenty of fresh produce that allowed for healthy choices. The service users were seen to be comfortable making their own drinks and helping themselves to food. Some said that they like helping with menu planing and cooking whilst others were not so keen. The dining areas in both houses Evidence: are pleasant, clean and homely. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home promotes the health and well being of the service users. Evidence: There is a written plan of support for each service user. These are important documents. This is because they form one of the means by which the service users and their supporters can be tell that they will be supported in the manner of their choice. Also, the plans are a source of reference information for the care workers who need to ensure that they assist people in a consistent and appropriate manner. Five care plans were examined. These have been recently reviewed and completely revised by the new manager. They are in very good order and record aspirations, likes, dislikes, cultural and religious needs, preferred activities and agreed goals. The care plans could be improved by giving a time scale for each goal and more positive daily recording. There is good evidence that the service users are fully involved in their care planning. There are regular planning meetings and a written record of these meetings is kept. The home has a keyworker system. This means that each service user has a named member of staff to support them. The care plans showed that the appropriate health and social care professionals are consulted. All the service users are registered with local GPs and visits to consultants and other hospital and health care appointments are recorded. The service users were all in good health on the day of this visit and said that they are well cared for and supported in the home. There are sound medication policies and procedures in place. Medicines are stored in a locked cupboard in a locked room. There is accurate recording of the administration of medicines. Medicines are stored safely and securely. It is good to note that two service users self medicate. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home listens to the concerns of the service users and their supporters and acts appropriately. There are sound policies and procedures in place for dealing with concerns, complaints and safeguarding of vulnerable people. This means that the service users are listened to and that the home does all it can to protect them from all forms of abuse. Evidence: There is a clear complaints policy and procedure that is available to all the service users. It is contained in a folder in the dining room of each house. Service users spoken to said that they know that they can talk to their key worker or the manager if they have any concerns or complaints. Staff have received training in the protection of vulnerable people. Those spoken to were all aware of safeguarding procedures and said they would have no hesitation in reporting any concerns to the manager. They said he operates an open door policy and is very approachable. Staff have received training in the protection of vulnerable people. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is clean and well maintained. This gives the service users a pleasant and homely place in which to live. Evidence: The home is currently undergoing a major refurbishment programme. The kitchens in both houses have recently been replaced. They are now bright and clean. The lounges have been redecorated and new furnishings provided. New carpets have been laid in some communal areas and new carpets will soon be fitted to the halls and landings. Outside a large conifer tree has been removed to make the garden lighter. The garden is soon to be landscaped. All areas of the home were clean and pleasant smelling on the day of this visit. The annual quality assurance assessment, the AQAA, that the home sent to us, told us there are regular checks made to ensure that the environment is safe and well maintained. All areas of the home were clean and pleasant smelling on the day of this visit. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staffing levels, staff training, staff morale and staff recruitment practices are all good. This means that the service users are supported by a well qualified, cohesive and cheerful staff team Evidence: Since the last inspection there has been a change in the organisational structure. This has made staff roles and responsibilities clearer. Staff rosters show that there are enough staff on duty to meet the needs of the service users. Recent recruitment has been encouraging and agency staff do not have to be used. This is good as it means there is more continuity of care for the service users. The files of the recently recruited staff members and two other staff files were examined. All were in good order. There was evidence to show that all necessary pre employment checks had been carried out. Satisfactory Criminal Records Bureau checks and two written references were on files as well comprehensive employment and education histories. Staff said that they enjoy working in the home and that there is good team working. They said that communication had greatly improved since the new manager had been appointed. This has led to improved staff morale. Staff said that they get plenty of training and supervision. A high proportion of staff hold recognised formal qualifications. Four staff members hold the National Vocational Qualification at level two, two staff members hold the National Vocational Qualification at level three and two hold university degrees in psychology. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is well managed and run in the best interests of the people who use the service. Evidence: A new manager has been appointed since the last inspection. He has worked at the home for the past for two years as a senior support worker. Prior to this he had fifteen years experience in a number of care settings. He is holds the National Vocational Qualification in care at level three and is studying for the National Vocational Qualification in Care at level four and the Registered Manager Award. He is in the process of preparing his application for registration with the CSCI. Conversation with the manager showed that he has a good understanding of client need and of best practice in care. He is currently in the process of applying for registration with the CSCI. Staff said that the management of the home has improved a great deal since his appointment. They said he is always available if they have concerns and that he is prepared to pull his weight. There are good quality assurance systems. A representative of the company that owns the home visits regularly and carries out inspections to make sure the environment is being maintained properly and that the service users are being well cared for. The home seeks the views of the service users at regular house meetings. The people who use the service and staff said that they feel confident in putting forward ideas. Ideas are discussed freely and put into practice if agreed and appropriate. There are sound health and safety policies and procedures in place. Examination of a Evidence: sample of these records showed that regular checks are made. Conversation with staff showed that they are well aware of health and safety requirements and have had appropriate training. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 1 6 14 (2) Where changes in needs, 31/01/2008 goals or aspirations are identified the care planning process must reflect how people will be supported with this. 2 20 13 (2) The registered person must 31/01/2008 make sure that there are safe arrangement for the administration and record keeping for medication in that: There must be a clear audit trail of medication received into and leaving the home. There is clear guidance on individual service users medication. There are regular reviews. Medication supplied by the pharmacist must be at the correct dosage. MAR sheets must correspond with the information on any boxes or bottles. Boxes and bottles should be dated as when they were opened in order to monitor any expiry dates. 3 24 23(3) (a)(ii) The registered person shall 29/02/2008 provide for staff suitable facilities and accommodation including storage facilities that is lockable for personal belongings and medication. This requirement had not been fully met with an original timescale date of 06/04/07. Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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