Inspection on 05/02/09 for CWAC Dover Drive

This is the latest available inspection report for this service, carried out on 5th February 2009.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2010.

CARE HOME ADULTS 18-65 CCC Dover Drive 18 & 20 Dover Drive Ellesmere Port Cheshire CH65 5BP Lead Inspector Ms Julie Porter Unannounced Inspection 5 February 2009 14:00 CCC Dover Drive CCC Dover Drive.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 CCC Dover Drive CCC Dover Drive.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. CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service CCC Dover Drive Address 18 & 20 Dover Drive Ellesmere Port Cheshire CH65 5BP 0151 3551157 01513571124 sue.ridley@cheshire.gov.uk http/www.cheshire.gov.uk Cheshire County Council 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) Susan Ridley Care Home 6 Category(ies) of Learning disability (6) registration, with number of places CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 2 The home is registered for a maximum of 6 adults in the category of learning disabilities, aged 18 to 65 years, receiving respite care. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection. 25 April 2008 3 Date of last inspection Brief Description of the Service: 18-20 Dover Drive is a care home that provides respite care for people aged 18 and over. It is owned and managed by Cheshire County Council. People who use the service are allocated respite days depending on individual needs and availability of the type of room they require. The statement of purpose says: service users will spend no more than 12 weeks in any one visit. Dover Drive is situated less than a mile away from Ellesmere Port town centre close to all local amenities. The home is divided into two separate living areas. Number 18 has two beds and number 20 has 4 beds. There is an internal door between the two houses that can be locked if necessary. The design of the building is to enable people to have a service that is suitable to their needs. Those people who have any behavioural problems will be kept separate from those users who need a more settled environment. Staff at the home will decide on allocation of the respite services and which service users will be allocated which room. The home is a single storey building with suitable access for all the people who use it. It also has ceiling track hoists to help people who have mobility problems to move around more easily. The current daily charge for each service user is available from the manager. CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. This unannounced visit took place on 05 February 2009 and lasted 5 hours. A further visit was made on 11 February 2009 to discuss the findings with the manager; this lasted 2 hours. The visit was carried out by one inspector. The report will say ‘we’ when referring to our activities and findings, as it is written on behalf of the Commission for Social Care Inspection. This visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about services in the home. CSCI questionnaires were also made available for people using the service, their families, and health and social care professionals, such as nurses and social workers, to find out their views. Other information received by CSCI since the service was registered was also reviewed. During the visit various records and the premises were looked at. All of the people staying in the home at the time of our visit were spoken with. What the service does well: What has improved since the last inspection? Information about the person’s needs is obtained and available in the home before they come to stay so that staff are aware of their needs and what they should do to meet those needs. CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 6 All the home’s staff have received medication administration training so they know how to give medicines to people safely, without errors. All staff working in the home have received training in protecting vulnerable adults so that they are protected from harm. 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. CCC Dover Drive CCC Dover Drive.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 CCC Dover Drive CCC Dover Drive.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): 2 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. People staying in the home have their needs checked before they are offered a service so that they know their needs can be met when they stay at the home. EVIDENCE: There is information available what is provided at Dover Drive respite service. This makes it clear that the purpose of the home is to provide short stays for people so their usual carers can have a break. On the day of our visit we found that two people had been living in the home, one for a period of over six months and one for over a month. This means that the home was not following its own stated purpose and people needing short stays may not have been provided with these because no places were available. On the day of our visit we looked at the care file of one of the newest people to start staying in the home. There was a completed form that showed that staff from the home had checked on the person’s needs to make sure these could be met at the home. This also included information from the person’s usual carers to guide staff on the best way to support the person in the way the person preferred. CCC Dover Drive CCC Dover Drive.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): 6, 7 and 9 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Care plans and ‘listen to me’ books provide information about each person so that staff know how to meet their needs when they stay at Dover Drive. EVIDENCE: The home offers a respite service where people usually come for short stays only. People staying in the home and their families complete “Listen to me” books so that staff are given information of how to best support them. One care plan we looked at contained valuable information on how the person needed to be supported during their stay in the home. As the home only offers respite care, health information is obtained before each visit to make sure that the records are kept up to date and staff know what each person’s health needs are at the time of their stay at Dover Drive. The plan we saw contained information on how to communicate with the person who had very limited verbal communication. This means that staff had good information to help them understand and communicate with the person CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 10 more effectively to make sure their needs were being met. There were also basic risk assessments in place and further work was being done on this as the staff got to know the person better. This helped to make sure that the risks to the person were accurately identified as staff got to know them better. One person we spoke with told us that they felt safe and were enjoying their stay in the home. All the people staying in the home continue with their usual activities when they stay at the home; for example, they continue to attend day centres and work placements. This helps to make them feel more settled because they can continue to take part in their usual routines. On the day of our visit we saw people preparing the go out for the evening to a local club. CCC Dover Drive CCC Dover Drive.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): 12, 13, 15, 16 and 17 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. When people come to stay at Dover Drive for respite, they are encouraged and supported to continue with their usual activities, so they can maintain their skills and friendships. EVIDENCE: Dover Drive provides short-term care for people who have multiple or profound disabilities and, in many cases, people who use the service are not able to take part in community leisure activities without help. During their stay at the home, people tend to follow what would be their normal routines, the same as when they live at home. The organised local authority transport continues to pick them up and return them from various day centres. This helps them to keep their familiar routines, to maintain their skills and their friendships. Sometimes because of the mix of people staying at the home, it may be difficult for people to go out as they may have different interests, or a high CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 12 number of people staying have mobility difficulties which restricts the possibility to get out. We were told that the staff rotas have improved since our last visit to Dover Drive. This helps to provide some flexibility in the evenings and at weekends so staff can plan activities people staying at the home. During our visit we watched the staff and they were very good at keeping the people who were staying at Dover Drive occupied and involved with what was going on. Reading, playing games, household chores and relaxation were all taking place before and after the evening meal. Staff prepared the meal on the day of the visit; however there were photographs in the home that showed that people staying in the home were involved in preparing food, according to their abilities. Menus are planned with people staying in the home. The staff are aware of each person’s likes and dislikes and any dietary needs, like soft diets, diabetic or cultural dietary requirements. This helps to make sure that people have the food they prefer so they can enjoy a varied, nutritious diet during their stay at the home. CCC Dover Drive CCC Dover Drive.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): 18, 19 and 20 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The health of the people staying in the home is monitored by staff so that they continue to receive the support they need. EVIDENCE: Throughout our visit we saw staff chatting with the people staying at Dover Drive, preparing for the evening meal, supporting them with settling in and unpacking and preparing to go to a disco. One person spoken with said that he was waiting for somewhere new to live. People staying at the home appeared comfortable with staff; some were laughing and sharing jokes. Records we saw during our visit showed people’s health care continues to be met by healthcare professionals in the same way if they were at home with their families. This makes sure that their healthcare needs are being met whilst they are staying at the home. CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 14 There are policies and procedures are in place on medicine administration and staff receive training so they can give medicines to the service users safely. The manager provided us with information that all staff working in the home have received medication administration training. This makes sure that they know how to give out medicines safely and makes it less likely that mistakes will be made. People staying at the home have the chance to look after their own medicines and staff from the home do a check to make sure that each person is able to do this safely. If they are not able to, staff will give out their medicines to make sure that mistakes are not made and the person gets their medicine as prescribed. CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 15 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 and 23 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Cheshire County Council’s policies, procedures and staff training are in place in relation to adult protection to ensure that people who stay at Dover Drive are safeguarded from harm. EVIDENCE: Cheshire County Council has a clear complaints procedure available to families and people who use its services, including those who stay at Dover Drive. Due to their communication difficulties, a large number of the people who stay in the home would find it very difficult to make a complaint during their stay. This was discussed with the staff on duty who said that they watch for physical signs or behaviour that may indicate that a person was not happy. They then try to respond accordingly, giving people alternatives or moving them to a different environment, but realistically it was often trial and error. The manager and senior staff told us that they also hold regular carers’ meetings so that matters can be raised and addressed less formally. The manager provided us with information that all eight staff have received training on safeguarding adults from abuse since out last visit to the home. This means they have received information about what abuse is and what they need to do to protect the people staying at Dover Drive from harm. No referrals have been made under the local safeguarding procedures from the home. CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 16 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 and 30 People who use this service experience excellent outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home was built as a small care home and is well looked after, with good adaptations, so that people staying there are comfortable and safe. EVIDENCE: The home continues to be well maintained. The manager told us of some improvements due to be made to the home to include more suitable window blinds. The home is divided into two separate living areas with an internal door that can be locked if necessary. Number 18 has two bedrooms and number 20 has 4 bedrooms. The design of the home means that it suitable for the needs of the people who stay there. For example, people who may have behavioural problems can stay apart from those who need a more settled environment. For this to happen effectively, more work needs to be done on matching the needs and preferences of the people staying at the home at any one time. CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 17 The home’s heating system has been carefully chosen to be safe for the people who stay at the home. The radiators are fitted to the ceiling and there are regulators on the walls. This means that there is no risk of people hurting themselves on radiators and that the temperature can be adapted to suit their preferences. Bungalow number 18 has a well-equipped kitchen, lounge/dining room and utility room. There is also a sluice room, which helps to make sure that infections are not spread through the home. Bungalow 20 has a well-equipped kitchen that can be used by people in wheelchairs, a lounge, a dining room and a utility room with a sluice. All the bedrooms have en-suite facilities; 4 bedrooms have showers and ceiling hoists over the beds and 2 bedrooms have specialist baths fitted with the ceiling hoists running from the bed to over the bath. This means that the privacy and dignity of the people who stay at Dover Drive can be respected and that there is suitable equipment to help them move around safely. Each bedroom has adequate lockable storage, an electric adjustable bed and there are a variety of different chairs and tables available to suit the needs of the people who stay at the home. There is a call system in the home with pull cords in every bedroom and bathroom, linked to a display panel, so people staying at the home can call for help from staff at any time. There were no cords in the dining and lounge areas. The manager confirmed that all staff carry a pendant so they can activate the alarm call systems as well as an internal phone so they can call for help for people when they are in these rooms. Dover Drive is kept clean and tidy by the support staff on duty. Staff have a suitable en-suite bedroom for sleeping in should this be required. CCC Dover Drive CCC Dover Drive.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): 32, 34 and 35 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Robust recruitment processes and training are in place to help make sure that staff are suitable and competent to care for the people who stay at Dover Drive. EVIDENCE: Since our last visit to Dover Drive, staff told us that they have been more settled and that there is now an identified staff team for the home, rather than staff from other parts of the service working there. Staff said that they felt this is working well. Six of the eight staff working in the home have achieved a National Vocational Qualification (NVQ) in care at level 2 or above. These are nationally recognised qualifications for people working in the field of care. Staff who have achieved them have been checked as competent and knowledgeable in providing care for adults. Individual training records are kept on computer and some copies of certificates were available on staff files to show what training and qualifications staff have achieved. CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 19 The records we saw during our visit showed there were still gaps in that some staff had not yet received updated training in essential areas. We discussed this with the manager who told us she thought the information in the records we saw was incorrect. After our visit, she provided us with information to confirm what training was still needed and a plan to show when this would be completed. At the time this report was written, all outstanding staff training would have been completed. We looked at the files of three members of staff. These showed us that thorough checks had been done, including getting satisfactory references and Criminal Record Bureau disclosures before the member of staff started working in the home. This helps to make sure that the staff are suitable to work with vulnerable people and so protects people from possible poor practice and abuse. CCC Dover Drive CCC Dover Drive.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 and 42 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home is well managed to make sure that it run the best interests of the people who stay there. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection. This involved checks being made to make sure she has the experience, knowledge and qualifications to run the home and be registered with the commission as its manager. Staff were complimentary about the support and guidance she offers them. One member of staff we spoke with clearly enjoyed their work in the home. At the time of our visit, the records we saw showed that staff have not attended all mandatory training. Since our visit, we received information to CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 21 confirm that all the necessary staff training would be completed by the end of March 2009. We saw that there were service contracts are in place for fire equipment and emergency lighting and that regular tests of these were being carried out. However, at the time of our visit, the records were being kept in several places, which could make it difficult to keep track that tests had been carried out when they were due. The tests are necessary to show that the equipment is working properly and that the home is safe for the people who live and work there. CCC Dover Drive CCC Dover Drive.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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 3 X 3 X X 3 X CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA35 Regulation 18(1)(c) Requirement Staff must achieve mandatory training and receive updated training relating to moving and handling, infection control, and fire training as identified in the plan. Timescale for action 31/03/09 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 CCC Dover Drive CCC Dover Drive.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Region Unit 1, Level 3 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 CCC Dover Drive CCC Dover Drive.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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