Inspection on 30/10/07 for Davie House

This is the latest available inspection report for this service, carried out on 30th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Davie House 31/12/05

Davie House 18/07/05

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Davie House 33 & 34 New Park Horrabridge Yelverton Devon PL20 7TF Lead Inspector Wendy Baines Unannounced Inspection 30 October 2007 10:00 th Davie House DS0000063500.V350490.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 Davie House DS0000063500.V350490.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. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Davie House Address 33 & 34 New Park Horrabridge Yelverton Devon PL20 7TF 01822 854656 01822 859348 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) www.care-ltd.co.uk CARE (Cottage and Rural Enterprises Ltd) Mrs Susan Denise Batley Care Home 8 Category(ies) of Learning disability (8), Physical disability (1) registration, with number of places Davie House DS0000063500.V350490.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 providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD 2. Physical disability - Code PD - maximum of 1 place The maximum number of service users who can be accommodated is 8. Date of last inspection 14th November 2006 Brief Description of the Service: Davie House is situated within the small village of Horrabridge, on the edge of Dartmoor in West Devon. The house is set in its own grounds, with a large attractive garden area. Horrabridge has several local shops, pubs, churches and park areas and is also within easy reach of the main road into the neighbouring town of Tavistock. The home is currently registered to accommodate 8 service users with a Learning Disability and offers accommodation on two floors, which include large communal areas and single bedroom facilities. The Registered Provider for Davie House is Cottage and Rural Enterprises (CARE). CARE is a Registered Charity and is overseen by a Board of Trustees. The organisation is Registered to operate 29 services across England, and currently provides 26 care homes and 3 Domiciliary Care agencies for people with a Learning Disability. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is a summary of a cycle of Inspection activity at Davie House since the last inspection visit. For the purpose of this report the term service user will be used to describe the people who use the service. To help CSCI make decisions about the home the Provider gave us information in writing about how the home is run; any documents submitted since the last inspection were examined along with the records of what was found at the last visit; two site visits totaling 10 hours were carried out with no prior notice being given to the home as to the date and timing; discussions were held with the Registered manager and staff on duty; various records were sampled, such as care plans and risk assessments; questionnaires were sent to a sample of staff ; and a tour was made of the home and garden; time was spent with the service users and the inspector was able to talk with, and observe the staff on duty. A sample group of service users were selected and their experience of care was tracked through records and discussions with staff and management from the early days of their admission to the current date, looking at how well the home understands their needs and the opportunities and lifestyles they experience. Where possible time was then spent with these service users, and feedback was sought from their care managers and other specialist services. This inspection approach hopes to gather as much information about what the experience of living at the home is really like, and to make sure that service users views of the home forms the basis of this report. What the service does well: Davie House provides a good level of care and support for the people who use the service. From the inspection visit and feedback from staff, service users and other agencies the service provides excellent support when assisting people with their personal and health care needs. The home completes comprehensive care plans detailing each individuals needs and how these should be met. People using the service are involved in writing their care plans and particular attention is paid to ensuring that information is documented about peoples likes, dislikes and preferences about how care is delivered. Care plans are reviewed regularly and written in a way that promotes choice and independence. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 6 The staff team have a range of skills and demonstrate particular compassion and understanding towards people with complex healthcare needs such as Dementia. People are supported to partake in community activities, work placements and a range of appropriate social/leisure opportunities. Staff are keen to ensure that an individuals disability should not act as a barrier to a good quality of life. The home has a good relationship with the local health care and specialist Learning disability services and feedback from these agencies was positive. The meals in the home are good offering both choice and variety. Staff demonstrated skill and understanding when supporting people with special dietary needs and are sensitive, patient and respectful when supporting people who require assistance with eating. Staff are well supported by regular supervision, opportunities for training and an open, positive and inclusive style of management. What has improved since the last inspection? The homes Statement of purpose and service user guide has been updated to inform current and prospective service users of recent changes to the home and services provided. The home is currently undertaking a review of all information available to people who use the service to ensure that it is in an appropriate format to enable people to have control, make choices and express their views about where they live and the services they receive. An additional training tool has been purchased to support staff to further develop their skills regarding service user choice and independence. The home has assistant one person to purchase a car, which will be used with staff support to enable the service user to access opportunities outside the home setting. People living in the home have made a decision to re-organise the dining area within the communal part of the home. Service users spoken to said that the change has provided a more comfortable and appropriate setting for people to enjoy their meals. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 7 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. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 1,3,5. This judgement has been made using available evidence including a visit to this service. People are provided with good information about the home and the services they can expect to receive. The home in liaison with other agencies regularly reviews the needs of people who use the service to ensure that their needs are being adequately met. EVIDENCE: Since the last inspection the home has reduced the number of people they support from 12 to 8. The three people who no longer live in the home are now receiving individualised support within their own accommodation. The information available to people who currently live or who may to choose to live at Davie House has been updated to reflect these recent changes. Current and prospective service users are provided with a Statement of Purpose and service user guide, which details information about the home and services provided. Although the service user guide is available in a pictorial format the manager said that this was being reviewed to look at further ways of making the information more appropriate to the people who may need to read it. Most of the people currently living at Davie House have lived there since the home opened and have a diverse range of support needs. Records confirmed Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 10 that the home regularly assesses the needs of all service users to ensure that the appropriate support and care is being provided. The manager said that in addition to their own assessment and care planning process Social Services are also in the process of undertaking assessments of all people living in the home to determine their long- term care needs. There had been no new people admitted into the home since the last inspection. Copies of service user contracts were available within files. These had been signed by the individual and/or their representative. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 6,7,8,10. This judgement has been made using available evidence including a visit to this service. The home has a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. People living in the home are involved in decisions about their lives, and play an active role in planning the care and support they receive. EVIDENCE: A sample group of three people were selected and their experience of care was tracked through records and discussions with staff and management from the early days of their admission to the current date, looking at how well the home understands their needs and the opportunities and lifestyle they experience. As part of this process the inspector was able to spend time with these people, observe the care being provided and in some cases speak to other agencies and people involved in their care. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 12 Each person had a well -structured and detailed care plan. The plans were written in a way that promotes choice and independence and had taken into account individual preferences about how the support should be delivered. In addition to the support details for staff each service user has a ‘ Person Centred Plan’, which, describes their skills and how they want to live or work towards their dreams and wishes. The manager said that the home has recently purchased a new training/support package for staff to develop the skills to empower service users and help them achieve the things they value. This is also being used as part of the organisations aim to support people who may be expressing a wish to move on from Davie House in the future. It was evident that the Person Centred Plan was owned by the individual and those spoken to said that they kept them in their rooms and met regularly with their key workers to discuss any issues. One service user spoken to was very clear about their wish to move from the home into a more independent setting. This information was clearly documented within the homes care plan and individuals Person Centred Plan. The service user said that they believed the home fully understood their wishes and were providing good support to help find a flat or other suitable accommodation. An independent advocate was also involved to assist the service user with these plans and arrangements. Service users spoken to said that there had been lots of changes in the home and staff had talked with them about their thoughts and plans for the future. Two service users spoken to said that they would one day like to consider moving from Davie House into their own flat. It is recommended that the home has a system to ensure that an action plan is in place to address the individuals’ goals and wishes identified in their personal plan, and that all service users have access to independent advocacy services as part of this process. Throughout the inspection staff were observed using their knowledge and skills to encourage and support service users to make choices and have control over their lifestyle. One service user had recently been into hospital and the home had worked with him prior to admission to develop a communication aid to ensure that he could communicate his needs and be understood by those providing care. Care plans confirmed that people living in the home have a range of skills and support needs relating to the management of their finances. Everyone had their own bank account and where possible were being encouraged to look after their money and participate in purchasing their own personal items. A Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 13 clear record was available of all expenditure, and money kept in the home was safely stored. All of the homes policies and procedures relating to the management of money are aimed at protecting and supporting the individual, however the manager said that the arrangements are flexible to ensure that they meet the needs and wishes of the individual concerned. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. 11,12,13,14,15,16,17. This judgement has been made using available evidence including a visit to this service. People who use the service are able to make choices about their lifestyle, and supported to develop their life skills. The meals are balanced and nutritious and staff are sensitive to the needs of people who have special dietary requirements or need assistance with eating. EVIDENCE: The atmosphere in the home was warm and welcoming. Several service users were getting ready to go out and others were either attending to morning chores or enjoying a leisurely breakfast. Service users were happy to meet with the inspector and were keen to share information about their daily routines, plans for the day and other opportunities and holidays they had enjoyed since the last inspection visit. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 15 The manager said that the home aims to ensure that complex care needs are not a barrier to having a good quality of life and experiencing different opportunities. She said that the home had recently supported one person with a high level of care needs to purchase their own car so that staff can support them to access opportunities outside the home. Service users spoken to said they enjoyed going to the local shops, pubs and leisure facilities. Some service users have regular work placements and others attend music and drama groups. One service user has a keen interest in gardening and has been supported to plant and maintain their own rose garden in the grounds of the home The information provided by the home prior to the inspection stated that some service users have work placements in a local charity shop, conservation project and recycling centre. Information in service user plans detailed these arrangements. A notice board was available in the home with information about local events and important dates. Service users are supported by their key-worker to plan a holiday each year and photographs were available of a summer caravanning trip. The home supports service users to maintain their links with family and friends and several service users were keen to tell the inspector about their friends, family and visits home. One service user was being supported by the home to visit a family member who had been unwell. Throughout the inspection staff were observed treating people in a dignified and respectful way. One member of staff showed particular awareness of issues relating to people rights and privacy by asking a service user if she could go into her bedroom to look for an item of clothing that had gone missing. The inspector joined service users for a lunchtime meal. Since the last inspection changes have been made to the dining area and service users spoken to said that they had decided on these changes and felt that the new layout was more comfortable and appropriate for everyone. The service users confirmed that they have a choice of diet and the opportunity to participate in preparing meals if they wish. On the day of the inspection several service users were assisting staff in the kitchen with the lunch and preparation of the evening meal. Due to the diverse needs of service users living in the home different levels of support were required during mealtimes. Details of these support needs and special dietary arrangements were documented in individual service user plans. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 16 The mealtime was unrushed and staff demonstrated particular sensitivity and understanding to service users who required support with eating and drinking. One service user had had recent eating difficulties due to an admission to hospital. The home had liaised closely with the hospital and dietician to ensure that they were providing the correct care and support during this time. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is excellent. 18,19,20,21. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity, and privacy are put into practice. EVIDENCE: Service user records included information regarding personal and healthcare needs. The information was detailed and included people’s daily routines and personal preferences about they want to be supported. Staff spoken to were very aware of each individuals personal and healthcare needs and were very familiar with the specific guidelines written within the care plan. Staff recognised the importance of consistency particularly for people with complex care needs and communication difficulties. Daily charts, communication tools, handover meetings and a key-worker system are used to ensure that health is monitored and any changes addressed as soon as possible. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 18 One service user had had a recent admission to hospital and the home had helped the gentleman produce information called ‘ about me’ to assist the hospital and to ensure that the service user had his needs met during this time. Detailed information was available regarding the care needs of a service user with Dementia. The specialist Learning Disability team and Dementia screening service were regularly visiting the home to review the care plan and to offer support and advice to those providing care. Staff had attended ‘ Dementia care’ training and were observed providing support in a gentle and respectful manner. Records confirmed that the home regularly liaises with outside agencies including the specialist Learning disability service, dietician and speech and language department. Feedback provided from these services was positive. Medication records were available for each service user. Detailed information was available regarding the individuals’ health, current medication, reason for taking and any possible side effects. Specific guidelines had been completed for people with more complex healthcare needs such as Diabetes. Records inspected were found to be in good order and up to date. A senior member of staff described the homes medication procedures, which included safe systems for storage and administration. All staff that administer medication receive regular training and any changes to an individuals health or prescription is discussed in the daily handover meeting. Service users who have been assessed as being able to self-medicate are supported to do so and have a lockable storage facility provided. The manager said that the home aims to support more service users to develop their skills and have more control over issues relating to their health and management of their medication. Most of the service users have lived in the home since it opened, therefore they have seen each other getting older and for some people experiencing episodes of poor health. The staff demonstrated a good understanding of these changes relating to the ageing process and were able to support the people living in the home through these different stages of life. Staff and service users have had support from the specialist Learning disability service regarding ‘ Dementia’ care and how this affects the individual and people living with them. Staff had also supported one service user to maintain contact with a relative during a period of illness and were sensitive to their needs during this time. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. 22,23. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and have their views listened to. They have access to a robust complaints procedure, which ensures that their concerns and complaints are addressed in a timely manner. Staff are aware of peoples rights and have the skills, knowledge and guidance to protect them from abuse. EVIDENCE: The complaints procedure for the home was discussed with staff and service users. All service users spoken to said that they knew who to speak to if they had a problem and felt that the staff would do something about it. Most of the service users said they would speak to their key-worker about any concerns they may have. The home had a written complaints procedure, which was also available in a picture format and displayed in the home. The manager said that the home would be undertaking a review of all information available to people who use the service to ensure that it can be understood and this review would include the complaints procedure. All complaints and concerns dealt with by the home are documented with copies of correspondence, outcome and any actions taken. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 20 The manager and staff said that the home attempts to promote openness and inclusion to ensure that all service users are listened to and have their concerns addressed. Each staff member has a copy of the homes ‘ safeguarding’ procedures and those spoken to were aware of issues relating to abuse and protection. Training records confirmed that staff attend ‘ safeguarding’ training and discuss these issues within team meetings and supervision. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is adequate. 24,25,26,27,28,29,30. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable and well maintained. The home does not provide adequate access to ensure that people with a physical disability maintain their independence. EVIDENCE: A tour of the premises took place, which included all communal areas and a sample of service users bedrooms. Since the last inspection the home has reduced the numbers of people they care for and this has included some physical changes to the design and layout of the building. Prior to this change the home had a separate three bedroom self-contained unit, which could be accessed via a door just inside the main entrance. This part of the home is now no longer registered with the Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 22 Commission and is used for people requiring a more independent setting. The doorway leading into this part of the home has now been bricked up and is no longer used by people living at Davie House. During the last inspection service users had expressed concern about these changes, however those spoken to during this visit said that they were happy with the changes and did not think it had caused too many problems. Staff spoken to said that they had spent a lot of time with service users to ensure that they had any of their fears or questions addressed prior to the change happening. The home has no suitable access for people who use a wheelchair and service users spoken to said that although they are independent outside the building they have to rely on staff to lift their wheelchair over the threshold of the doorway. The homes statement of purpose says that they can provide a service for people with a physical disability, however, the current facilities do not ensure that people with a disability can access all parts of the home or maintain their independence. Service users bedrooms were found to be attractively decorated, clean and bright with décor and personal belongings that reflected their interests and personalities. One service user was keen to show the inspector their bedroom and the bedding and curtains that that they had recently chosen with support from their key-worker. The communal parts of the house were clean and tidy and service users described recent changes to the layout of the dining area, which they felt created a more comfortable environment for people to eat their meals. The general impression of the home would be improved by updating some of the décor and furnishings in the communal parts of the house. Discussion took place with the manager about the need to ensure that privacy is considered when service users are being supported in the communal parts of the house, particularly the main sitting room. Some of the people living in the home require 1:1 staff support to attend to personal care needs and the use of a range of specialist equipment to assist them. Two service users require a wheelchair inside and outside the building. The home has a range of equipment including specialist beds, hoists, slings and grab rails. However, the bathrooms in the home are small and staff spoken to felt that the size of these rooms were likely to cause a problem as people needs progress. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 23 Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 24 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): Quality in this outcome area is good. 31,32,33,34,35,36. This judgement has been made using available evidence including a visit to this service. Staff in the home have the necessary skills, training and attitude to support the people who use the service. The service has a good recruitment procedure, which involves and protects the people receiving care. The manager is supported well by senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: Staff demonstrated a good awareness of peoples needs and when spoken to were very familiar with care plans and specific guidelines for providing support. Throughout the inspection staff were observed interacting with service users on a one to one basis and in groups. There was a good rapport between service users and staff and the atmosphere in the home was happy and relaxed. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 25 Staff showed particular skill and compassion towards service users with complex care needs and demonstrated a good awareness of the needs of people with Dementia. One service user was feeling unwell on the day of the inspection and staff were observed offering regular cups of tea and kind words of reassurance. A sample of staff files were seen including the recruitment records of any new staff. All the required recruitment records were available and sufficient checks had been completed prior to appointment. On the day of the inspection someone was being shown around with a view to working in the home. Service users said that they always get to meet new staff and can ask them questions and feedback their views to the manager. The most recently appointed staff member described their induction process to the inspector, which included a period of working alongside other staff, reading records, policies and procedures and the completion of mandatory training such as Health and Safety, food hygiene and Fire awareness. Discussion took place with the Registered Manager about the wide range of care needs of people currently living in the home and the arrangements for staffing to ensure that everyone can have their needs met. The manager said that the home regularly reviews staffing levels and liaises with Social Services and care managers if they feel that peoples needs are not being met appropriately. Staff spoken to said they felt well supported by other team members and management. Key-worker and team meetings take place on a regular basis, and the rota allows for a shift handover to discuss daily events. Records confirmed that formal supervision takes place every 6-8 weeks and this information is documented. Questionnaires were sent to all staff and feedback received was very positive regarding the quality of care provided to service users and the support received by staff to fulfil their role Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 26 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): Quality in this outcome area is good. 37,38,39,42. This judgement has been made using available evidence including a visit to this service. The management approach is open, inclusive and positive providing clear guidance and leadership. The staff team work hard to provide service users with good information about the home and their care. The current heating system in the home do not allow for radiators to be covered. This may not sufficiently protect people from burns as they become frailer through age and/or ill health. EVIDENCE: Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 27 The manager and staff said that the home works hard to create an environment that is inclusive and open and recognises the rights of each individual. The manager said that she recognises that there has been a lot of uncertainty due to changes in the home and plans for the future. Records and discussion confirmed that staff have worked hard to support people through these changes and to help them consider their individual needs for the future. It is recommended that all people using the service have access to independent advocacy services to ensure that they are being supported at all times have control and make real choices about their future and the care they receive. The service users spoken to said they enjoyed living at Davie House and considered it to be their home. One service user said that Davie House had been a ‘ stepping stone’ and provided the skills needed to move into a more independent setting. The inspector was able to meet with the staff member responsible for Quality Assurance who described the assessments that are completed annually relating to; activities, relationships, choices, staff and health and safety. Key-workers support service users to complete questionnaires and the results are sent to the organisations head office Feedback from other agencies confirmed that the home regularly liaises with the people and services involved in an individuals care, however, the home does not have a system for regularly gathering or analysing feedback from relatives or other agencies. The current heating system in the home does not allow for radiators to be covered and some of the heaters were hot to touch. Risk assessments relating to burns and scalds have been completed and previous requirements relating to this issue have been addressed. However, as people living in the home become older and their care needs increase consideration needs to be given to the heating system throughout the home to ensure that people are safe at all times. A sample of health and safety records were inspected including; risk assessments, fire log and accident book. These were found to be up to date with copies of reports sent to the Commission when required. Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 28 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 X 3 3 4 X 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 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X 3 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 4 4 4 4 3 3 3 X X 2 X Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 29 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. 1. Standard YA24 Regulation Reg 23 Requirement The Registered provider must ensure that the premises are suitable to meet the needs of people they state they can provide a service to. Level access must be provided for people who use a wheelchair to ensure that they can access all parts of the home and maintain their independence as much as possible. The Registered person must ensure that all parts of the home to which the service users have access are so far as reasonably practicable free from hazards to their safety. Consideration must be given to ensuring that the heating system in the home allows for hot surfaces/radiators to be covered, particularly where risks have been assessed as high. Timescale for action 24/01/08 2 YA42 Reg 13. 24/01/08 Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 30 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA7 Good Practice Recommendations The home should have a system to ensure that an action plan is in place to address an individuals goals and wishes as identified in their ‘Person Centred ‘plan. In addition all service users should have access to independent advocacy services to ensure that they have control and can make real choices about their care and future living arrangements. 2. YA24 The general impression of the home would be improved by updating some of the décor and furnishings particularly in the communal parts of the home. The Registered Provider should ensure that bathroom and toilet facilities in the home remain adequate for the current and changing needs of people who use the service. Consideration should be given to ensuring an individuals privacy when supporting and providing care to people in the main sitting room of the house. This could be improved by fitting blinds or other screening to the large window. The Registered Provider should develop the homes Quality Assurance systems by seeking feedback from relatives and other agencies and publishing their findings to demonstrate the quality of the service. 3. YA27 4. YA28 5. YA39 Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Davie House DS0000063500.V350490.R01.S.doc Version 5.2 Page 32 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!