Inspection on 23/06/05 for 11 Friars Close

This inspection was carried out on 23rd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

11 Friars Close 10/07/06

11 Friars Close 05/12/05

11 Friars Close 13/12/04

11 Friars Close 04/08/04

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 11 Friars Close Dorchester Dorset DT1 2AD Lead Inspector Marion Hurley Unannounced 23 June 2005 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 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 Stationary 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. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 11 Friars Close Address Dorchester Dorset DT1 2AD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01305 263479 Leonard Cheshire Mrs Glynis Elizabeth Baker CRH PC - Care Home Only 3 Category(ies) of LD Learning disability (3) registration, with number PD Physical disability (3) of places 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Mrs Baker to undertake an adult protection managers course (agreed suitable by the Commission) by September 2005. Date of last inspection 13 December 2004 Brief Description of the Service: 11 Friars Close is a care home providing personal care and accommodation to three adults who have a learning disability and additional physical disabilities. The home is one of seven similar services in Dorchester that are owned and operated by the Leonard Cheshire Foundation, a ‘not for profit’ organisation providing services to people with disabilities. The registered manager is Mrs Glynis Baker, who is based at the provider’s local office in Alexandra Road, Dorchester. The home is located in a popular residential area on the outskirts of Dorchester, within walking distance of the town centre. Dorchester has a wide range of shops, banks, GP surgeries and other amenities, which are used by service users on a daily basis. A structured day programme is also provided to the service users. The home has the use of an adapted vehicle. The home is staffed 24 hours a day, with at least 2 members of staff on during the day and one member of staff sleeps in. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection has been undertaken as part of the statutory inspection process in accordance with the Care Standards Act, 2000. Friars Close was assessed according to the Care Home for Adults (18-65) National Minimum Standards. The overall time spent to complete the inspection process was a total of five hours, two of which was spent at the Home. In the course of this inspection both the Registered Manager and Responsible Individual were available and two members of the staff team. One resident was at home but did not participate in the process of the inspection. All records, documents and files were easily accessible on the day. The premises and garden are suitable to meet the needs of the three residents. From discussions with staff it is clear there is positive job satisfaction and they genuinely enjoy the company of the residents. This was a positive inspection of a service that continues to develop and aim for high standards of practise working side by side with residents with varying abilities and complex needs. The inspection process was assisted by the openness of the staff and management and the inspector was grateful for their time and commitment to the inspection. What the service does well: What has improved since the last inspection? Since the last inspection the Registered Manager has made a commitment to ensure that all staff receive regular supervision and this is being achieved. The Registered Manager and staff have begun to redesign and develop the existing Care/Service Plans into Person Centred Plans. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 6 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. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed as no new service users had been admitted to the home since the last inspection. The key standard will be assessed at the next inspection visit. EVIDENCE: 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 8 & 9 • • • Care Assessments and Plans are in use for each of the residents, which specify the services and facilities available to them. Residents are encouraged to participate and make decisions in all aspects of their daily lives to enable them to retain as much independence as possible Within the limits of the residents’ personal abilities, each is supported to take appropriate risks, which promote self-determination. EVIDENCE: The Registered Manager and staff have recently designed a pictorial profile /plan for one of the residents. This has been creatively done with a picture of the resident in the middle with key information about their likes and dislikes scattered out from the centre. The ideas and principles from this support plan should be developed and used further with the other residents. In addition to the new style used for one resident the other two each have a support plan, which is a combination of care assessments, and care planning. These documents contain a lot of relevant information but do not give the reader a feel of the person and this is partly due to some of the terminology used which refers to people as “ clients”. The care/support plans set out how 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 10 residents current needs should be met but do not clearly identify short /long term goals for each person. Some care and risk assessments had been reviewed whilst others had not. The risk assessments were generic and not specific to the individual person (in name only) and because they had not all been reviewed there was no evidence to indicate how that person’s behaviour may have changed and developed since the assessment was originally completed. There is a need for communication profiles to be drawn up which include an inventory of the communication methods and specific signs used by each resident, and for staff to have access to professional and/or ‘in-house’ training in Makaton and PECS. Discussions with the two members of staff on duty during the inspection visit clearly indicated their knowledge and understanding of the residents in the Home. The work they undertake side by side with the residents is based on achieving both long and short-term goals and it is important these achievements and goals are recorded to reflect this work. All residents have an annual review and the Registered Manager advised this is generally conducted with the funding authorities and forms the basis of the annual contract. In addition to these reviews all assessments/plans should be reviewed every six months to reflect any changing needs/abilities. This standard was verified through reading the residents support plans and discussing details with both the staff and Registered manager during the inspection visit. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 16 • One resident goes to Day Services, which provides stimulating and age appropriate activities with his peers. The others residents are given appropriate opportunities to learn and develop through participating and experiencing a wide range of leisure and daily living activities both at home and in the local vicinity. Residents, with staff support and supervision access local amenities and resources, which enhance the residents’ local network and understanding of the community in which they live. Staff treat residents with respect and this forms the foundation of a positive and respectful relationship between staff and residents. Residents are afforded privacy and personal space • • EVIDENCE: All the residents have varied weekly routines that include many activities away from the Home. These include attendance at Day Services, in addition to a wide range of leisure activities. Evidence for these standards was obtained from reading the individual diaries kept for each person, care plans and through discussion with members of staff on duty. One resident is particularly fond of music and has their own keyboard another likes all outdoor activities and has had a go at canoeing and rambling. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 • Staff provide flexible support and personal care for each resident ensuring their health and general well-being is carefully monitored and maintained EVIDENCE: Residents are not able to take control of their own healthcare needs, however with staff support all residents access local HNS resources and services routinely and ‘as required’. Each resident has a written support plan which incorporates aspects relating to their health and general well being but there was not sufficient evidence in the records to indicate the moving and handling assessments were regularly reviewed to meet the resident’s changing needs. A record of health care appointments and outcomes with health and other related professionals were available in the resident’s files and indicated that health care needs were being met. Behavioural and emotional changes are carefully monitored and staff work closely with Specialist nurses and Consultants who attend “house/staff meetings” to establish realistic methods of supporting residents to encourage their potential and life experiences. The outcomes for these standards were evidenced through discussion with the two staff on duty at the time of the inspection visit and detailed reading of the records for one of the residents living at Friars Close. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 13 All the residents rely on staff to totally manage, store, and administer their medication it is therefore essential that those staff completing any tasks relating to the residents medication must complete an accredited course in The Safe Handling of Medication. It is understood that Leonard Cheshire Homes, Dorchester have recently agreed a contract with Boots The Chemist and the first training course has been scheduled for July 2005. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 • The current group of residents would have great difficulty in understanding the concept of a complaint or information on the subject. However, from observations it was evident staff listen and watch the resident’s different patterns of behaviour to ascertain and understand the wishes and views of each resident. EVIDENCE: The Registered Manager with the staff team need to develop ways to support the residents to raise concerns/ complaints and to consider how to produce a complaints procedure in a format that might be recognisable by the residents. All the residents have different levels of comprehension and each has developed their own method of indicating their pleasure or apprehension. It was evident from talking with the staff on duty that they had a good understanding and practical interpretation of the resident’s behaviour and this sensitivity allowed the staff to recognise the wishes and concerns of residents. This is good practice and should be recorded in the resident’s support file to ensure continuity from all staff when understanding the different communication methods of each resident. No complaints or concerns have been raised since the last inspection. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 • • Friars Close is a family style home and is suitable for the needs of the people living there. On the day of the inspection the premises were clean, creating a safe and comfortable environment for both residents and staff. EVIDENCE: A partial tour of the premises was completed. The facilities are appropriative for the needs of the group with one ground floor bedroom available for the resident who is a wheelchair user. The home is bright and in good decorative order though the side porch needs attention and the gardens front and rear need some tidying. The home has a domestic style washing machine and tumble drier. The washing machine has a cycle, which will wash, to temperatures of 95 degrees centigrade. Any foul laundry is washed in dissolvable sealed “red bags”. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 & 36 • All staff receive regular supervision and the support they need to carry out their jobs. This contributes to maintaining a quality staff team working for the benefit of all the residents. EVIDENCE: Both the staff on duty said they were currently studying for NVQ’s. One person has just commenced level 3 and the other recently qualified to teach Manual Handling. Both have completed the Introductory Learning Disability Award Framework (LDAF) training course. The training undertaken by these two staff validated the Leonard Cheshire Foundation commitment to equip staff with appropriate skills and competencies through generic and specialist training specific to the needs of residents. Both the staff on duty had completed Team Teach (the management of complex and challenging behaviours.) Both staff said they felt well supported by the management team and the supervision rota was working well with a regular commitment from staff and management to ensure supervision was completed. A file containing supervision notes was read and contained a useful “template” for standing items for the agenda, objectives, and action. Records indicated the supervision was being conducted within the recommended timescales. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 & 42 • Residents benefit from the Registered Manager’s experience and ability to run a relaxed but efficient home. The member of staff on duty at the time of this inspection confirmed the Manager’s approach and skills. Both the member of staff and the resident were observed to be happy and confident in the Manager’s presence during this inspection visit The Registered Manager is competent and experienced to run the home and is currently studying for NVQ level 4 in both management and care. At the time of this unannounced inspection safe-working practices appeared to be satisfactory ensuring a safe environment for both residents and staff however not all aspects of NMS 42 were met as all staff must receive fire prevention training every three months. • • EVIDENCE: Fortnightly “house meetings” are held with the staff team and Registered Manager. Both the Manager and support worker said they felt the meetings were productive ensuring information between all staff was kept up to date and the needs of the residents were continually under review with the resident’s behaviour and response to any changes being discussed. The support worker 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 18 described the meetings “as a time to reflect and brain storm ideas for working with the residents”. All minutes and notes from these meetings are kept and were noted. These meetings contribute to the on going self-monitoring however; no residents contribute to this evaluation. Despite the complex needs and behaviour of some of the resident both the Manager and staff had a very positive approach and sense of loyalty to all residents. The house is fitted with smoke and heat detectors in addition to fire extinguishers and blankets. All staff have completed basic first aid training and all members of the management team are Approved first aiders and available on a 24 hour call out basis. From discussions with the Manager it was evident they are fully aware of their responsibilities for the practical day-to-day health and safety issues for both residents and staff. However overall management responsibility for fire prevention, risk assessments and safe working practises is the responsibility of the designated “Health & Safety” employee who is based at the Dorchester Administrative offices. This person has completed a range of risk assessments. These assessments are generic and do not specifically relate to the individual residents and their different abilities and understanding of risk and personal safety. It is important these risk assessments are completed and regularly reviewed with or by staff that live and work side by side with the residents and who therefore have a good practical understanding of the residents abilities and needs. All electrical testing has been completed. Certificates and records verifying this information were readily available and checked. The designated responsible person, on behalf of Leonard Cheshire Homes, completes monthly visits. The reports are detailed and regularly provided to the CSCI offices. The last report in April 2005 indicated there were no areas of concern. Not all staff have received fire training within the required timescale. Both the Registered Manager and Training Co-ordinator are aware of this and ensuring all staff will now receive Fire Prevention Training at three monthly intervals. 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 11 Friars Close Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 2 x x 2 x D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 20 No 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 23 Regulation 13 Timescale for action All staff must receive appropriate 31st October, training in physical intervention and restraint. At the time of this 2005 inspection 50 of staff have completed training. Incidents of physical intervention/restraint must be recorded in detail and in a format which can be easily monitored by Management. Staff must be aware of the correct procedures to follow to protect residents from harm and abuse. The homes policy must inform staff of the correct procedures to be taken if they witness or suspect abuse. All staff must receive regular refresher training in the Protection of Vulnerable Adults. Previous timescale for action 01:12:04 The Home must establish & 31 st maintain a system for reviewing October the quality of care provided by 2005. the home which must include consultation with the residents &/or their representatives. The Registered Manager must 31 st ensure all staff receive fire October prevention training every three 2005. months. Previous timescale for action 01:12:04 Version 1.40 Page 21 Requirement 2. 39 24 3. 42 23(4) 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc 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 6 Good Practice Recommendations The individual care/service plans need to be written based on the principles of person centred planning and should include a record of the residents long and short term goals. Risk assessments should be reviewed regulaly and provide details of who has been involved/consulted with during the assessment process. Risk assessments must reflect the individual residentsabilties/needs and the hazards specific to them and the plan of action to minimize the hazards/risks All staff adminstering and handling medication must receive accredited training in basic knowledge of how medicines are used, how to recognise and deal with problems and the principles behind all aspects of the Homes policy on medicines. At the time of this inspection aspects of tis recommendation were actively being addressed.Each member of staff should have an individual training and devlopment assessment. Each member of staff should have an individual training and devlopment assessment. 2. 9 3. 20 4. 35 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole Dorset BH17 0NF National Enquiry Line: 0845 015 0120 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 11 Friars Close D55 S26739 11 Friars Close V219983 230605 Stage 4.doc Version 1.40 Page 23 - 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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