Inspection on 01/02/06 for 193 St Andrews Road

This inspection was carried out on 1st February 2006.

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 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

193 St Andrews Road 28/04/08

193 St Andrews Road 04/09/06

193 St Andrews Road 04/10/05

193 St Andrews Road 18/03/05

193 St Andrews Road 03/12/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 St Andrews Road (193) Bridport Dorset DT6 3BW Lead Inspector Marion Hurley Unannounced Inspection 1st February 2006 10:00 St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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 St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Andrews Road (193) Address Bridport Dorset DT6 3BW 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) 01308 425824 Dorset Residential Homes Mrs Cheryl Lisa Jarvis Care Home 8 Category(ies) of Learning disability (8) registration, with number of places St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2005 Brief Description of the Service: 193 St Andrews Road is a care home that provides nursing care and accommodation for 8 learning disabled people who may also have associated emotional and behavioural needs. The home is operated by Dorset Residential Homes, a registered charitable trust that operates a number of care homes in Dorset. The home is located in Bridport within easy reach of the town centre. It is a large detached property that has been carefully extended and adapted to meet the needs of service users; the home does not stand out from neighbouring properties. There are 6 single bedrooms and 1 shared room for service users; on the ground floor there is a lounge, kitchen, dining room and conservatory. There are bathrooms and toilets on both the ground and 1st floor. The home is staffed by a team of registered learning disability nurses and care staff, who provide 24-hour care and support. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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. 193 Andrews Road 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 seven hours, three of which were spent at the home with residents and staff. During the inspection records related to the specific standards assessed were checked. What the service does well: What has improved since the last inspection? The manager and staff team have developed a practical well planned emergency back up system and there is now an on call system available to staff working in the home. The refurbishment of the kitchen is fully complete and good use of magnet locks has been made to ensure some cupboards are discreetly secure. Resident’s assessments and records provide a good feel of the person and their likes, dislikes and personal preferences in the way they are supported and in the management of their care. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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 St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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 the following standard(s): The key standard was assessed and met at the last inspection. EVIDENCE: St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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 the following standard(s): 7 • Residents living at 193 are encouraged to make their own decisions about everyday matters, and the home will do its best to make sure these are understood and supported. EVIDENCE: Residents are encouraged to make as many decisions about their own lives as possible. To encourage this process each resident has his or her own Choice Plan and Activity Participation Record. The registered manager explained how these were written with each resident and their support team, which generally comprises one qualified member of staff, and two support workers. The choice plan identifies positive choices that are within the resident’s understanding, and each plan identifies one goal. For example one choice plan stated that the person “needs help to be more confident in making a choice”. Another choice plan identified the need to create opportunities for the resident to make informed choices. Opportunities for positive choices occur throughout the resident’s day and run through a 24-hour cycle starting with their preferred time for getting up, the clothes they choose to wear, how they are supported with their personal care St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 Page 10 needs, the food they eat and drink, activities throughout the day and finally to what time they want to go to bed. The participation chart is categorised into sections and staff score the level of participation according to the rating 1-4. The categories range from full choice, final choice but with limitations, final choice not with the resident but involved and finally not involved. The level and comprehension for each resident is entirely different and for some the choice needs to be narrowed down to two, others understand the concept of choice and make positive choices throughout the day. At the time of the inspection visit one resident was enjoying their breakfast, which they had chosen and prepared. Later in the morning one person went shopping and on return described how they had decided what to buy. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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 the following standard(s): 15,16 & 17 • Residents are supported to maintain links with their families and friends. • The rights of residents are respected and recognised within the home. • The meals in the home are good offering residents choice and variety. EVIDENCE: Residents make use of local facilities and one resident who had been shopping during the morning helpfully described to the inspector where they had been and what they had chosen to buy. Residents have different levels of contact with family and friends varying from weekly commitments through to “visits on special occasions. Where possible staff facilitate the arrangements and provide transport if required. Residents are friends with other service users supported though Dorset Residential Homes and also benefit from regularly meeting with their peers at Day Services and socially though the local Gateway Club. Resident’s when asked consider the staff “their friends”. Where residents have no extended family the Home tries to link them individually with an Advocate. Some residents living at 193 are local people and have many social acquaintances from the town of Bridport. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 Page 12 Residents are encouraged to choose and prepare their own breakfast and this may vary from a full cooked meal through to toast or cereals. Residents’ enjoy their main meal at mid-day and the selection for the day is geared around the residents at home on any given day. Residents are again encouraged to assist in the preparation particularly when staff know it is one of the resident’s favourite meals. The evening meal is generally a snack supper and again where possible residents are supported to make their own selection and assist with the preparation and clearing away. The dining room has four separate tables with two residents and one member of staff occupying each table. The registered manager explained how through discussions and observations staff have established where and with whom residents prefer to share a table with. i.e. one resident likes to sit by the window and this preference has been accommodated. A record of all food consumed is maintained and the records seen on the day of the inspection were up to date. Records of the temperatures of appliances are also maintained and these were noted. All staff have completed basic food hygiene training courses. Resident’s special dietary needs are recorded in their plans and these cross referenced with the menu/meals provided i.e. one person has a specific allergy another needs to be encouraged to drink more. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 • Residents are safeguarded by the medication procedures within the home. EVIDENCE: The registered manager confirmed that there are policies and procedures in place for all aspects of dealing with medication. Records of the administration of medication (MAR sheets) were looked at and all administration had been signed. There is a medication profile for each resident and a photograph. All staff as part of the induction training receive training in the safe handling of medication and their competencies are assessed prior to undertaking responsibility for administering and handling medication. One resident is currently managing their own medication and this has been agreed following an in depth risk assessment. There are clear instructions for the management of the medication and the resident is given one “dose “ at a time. This is safely stored in a tin and the old empty container is replaced with the next dose of medication. This system is working well and the registered manager stated that the resident “feels in control”. All residents have six-monthly medical checks and their medication is reviewed annually or more frequently if required. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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 the following standard(s): 22 & 23 • Staff are aware of the action to be taken should a complaint be made. • The home has appropriate systems to protect residents. There are both policies and procedures in place to help safe guard residents from potential abuse and harm. EVIDENCE: DRH has comprehensive policies and procedures for dealing with any complaints or allegations of abuse. The registered manager is confident all staff would be very clear on how to implement the correct strategies for dealing with situations, which may include allegations of abuse. The home has not received any complaints since the last inspection. Not all the residents use language to communicate however, the staff are very familiar with the different ways residents indicate their likes/dislikes and feel through individual behaviour and or gestures all resident raising a complaint or making an allegation would be listened to. One resident was asked if they felt the staff listened to them and they clearly told the inspector that staff did. Staff also felt they “reacted” to what resident’s said and /or indicated through their behaviour or non-verbal communication. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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 the following standard(s): 30 • 193 was found to be clean and odour free throughout the building. EVIDENCE: A partial tour of the premises was conducted with the registered manager and most aspects of the home were found to be clean and well maintained. Please refer to the summary for additional references regarding certain aspects of maintenance of the building. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 ,34 & 35 • Resident’s needs are currently being met with the number and skill mix of staff on duty. • Residents are safeguarded by DRH’s recruitment policies and procedures, which are being implemented at the home. EVIDENCE: Both staff and the registered manager spoken with said they were happy working at the home and stated that there were opportunities to attend training sessions. Two qualified nurses have recently been recruited and the records of one of these were checked. All references and statutory checks were available on file. Staff applicants are invited to visit the home prior to attending a formal interview and this allows time for the residents to meet with new staff and for applicants to get an initial feel of the home and the residents they might be working with. All new staff spend two weeks shadowing another member of staff and this opportunity allows them sufficient time to observe all the residents in their daily routines in the home. Part of this time is used for the completion of mandatory training and familiarising key policies and procedures. The induction period may last up to four months depending on the newly appointed staff’s previous experience. The current staff team consists of 8 qualified nurses and 13 support workers and 2 escorts for the drivers. The morning shift is from 07:30 –15:00 and the afternoon commences at 14:00- 21:30. This overlap allows for a St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 Page 17 comprehensive handover and sufficient time to de-brief if in any incidents have occurred during the shift. Many of the residents have complex needs and behaviours and require 2:1 staffing ratios. The registered manager is supernumerary on the rota. The night team consist of two qualified nurses and three support workers. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 &39 • Resident’s benefit from a home that is managed and run well . • In general residents or their representatives would feel confident their views were listened and reacted to. EVIDENCE: The residents living at 193 have different ways of communicating their choices and emotions with staff. Staff were observed carefully monitoring the residents as they set about their different activities, one person getting ready to go shopping, another managing their laundry and it was clear staff were sensitive to their behaviours but allowed the resident sufficient time to complete their tasks in their own way. The registered manager advised that families and other professionals attend the residents’ annual reviews/ Life Support Meetings and use part of that time to give feedback to the home. Residents are supported by a team of workers with each “team” comprising 1 qualified and possibly two support workers having responsibility for two residents. Every other month this “team” have what is called a “green day” when they are supernumerary on the rota and they use the day to review and St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 Page 19 monitor the care they provided to the residents and where necessary adjust the plans and support provided to ensure the on going and changing needs of the residents are met. The registered manager attends monthly management meetings with other managers from the DRH network of homes. In house bi- monthly meetings are held with all qualified staff and all staff complete quarterly in house performance reviews where an appraisal of their work is completed and an agreed plan for their on going training needs identified. The representative/ “responsible individual” for Dorset Residential Homes completes monthly monitoring visits. The Regulation 26 reports are sent to CSCI. These reports are comprehensive and extremely useful and practical in providing on going information. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 Page 20 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 x 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 x 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x 3 x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 3 x 3 x 3 x x x x St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA35 Good Practice Recommendations Staff training records need to be formalised into a practical filing system, which allows for an audit of staff training. Please note at the time of this inspection this work is in hand and progressing. St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole 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 St Andrews Road (193) DS0000020420.V279218.R01.S.doc Version 5.1 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. 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!