Inspection on 04/10/05 for 193 St Andrews Road

This inspection was carried out on 4th October 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

193 St Andrews Road 28/04/08

193 St Andrews Road 04/09/06

193 St Andrews Road 01/02/06

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 4th October 2005 14:00 St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 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.V252898.R01.S.doc Version 5.0 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.V252898.R01.S.doc Version 5.0 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.V252898.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th March 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.V252898.R01.S.doc Version 5.0 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 St Andrews Road, Bridport 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 six hours, two of which were spent at the Home. The Registered Manager was not on duty however both qualified nurses and support workers were available throughout the inspection process. One resident was at home and others returned later in the afternoon having spent the day at Day Services in Sherborne. On this occasion none of the residents were fully involved in the inspection process though two were introduced and observed for a short while. The premises and garden are suitable to meet the needs of the residents. The inspection process was assisted by the openness of the staff and the inspector was grateful for their time and commitment to the inspection, which for some was a new experience. What the service does well: The staff team have developed with the residents very detailed Daily Support Plans, which provide valuable information in understanding and supporting each resident to express their individual needs, likes and any dislikes. All the residents have very different methods of expressing their wishes and from discussions with staff they appear to have a positive approach and good knowledge, mixed with common sense, to deal sensitively with the different needs and wishes. There was evidence that good multi-disciplinary work takes place on a regular basis and this was especially evident in the records concerning the most recent person to move into the home. St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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.V252898.R01.S.doc Version 5.0 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.V252898.R01.S.doc Version 5.0 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): 2&3 • Prospective residents considering a move to 193 St Andrew’s Road have the opportunity to participate in a comprehensive assessment identifying their needs and aspirations. This process helps each to contribute in the decision making as to whether the home is somewhere they may want to live. • Moves are carefully considered and planned by the Registered Manager in liaison with other significant people in the prospective resident’s life. A placement is only offered if the person’s assessed needs can be met by the home’s facilities, services and team of staff. EVIDENCE: One resident has recently moved to the home and is still in the transitional stage of settling into their new lifestyle. Records in the resident’s file clearly demonstrated the excellent multi-agency work, which had been undertaken to ensure a positive and consistent experience for this person. Comprehensive assessments and plans had been completed which identified the person’s current needs and their choices for the future. Discussions with staff indicated their knowledge and sensitivity at managing this transitional phase for the resident. Discussions also indicated their awareness and understanding of the resident’s assessed needs and daily plan, which included management strategies to help understand the resident’s behaviour. On this occasion it was not possible to discuss the experience with the resident. St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 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): 6, & 9 • Individual assessments and Daily Support Plans were all contained in the resident’s personal files and regular reviews were noted which ensured changing needs were reflected. • Residents are encouraged to make decisions about their lives in the context of a risk management framework and this supports them to try new experiences and become as independent as possible. EVIDENCE: Each resident has a comprehensive file, which comprises clinical information including assessments and plans and another section identifying daily information. The Personal profiles are written using graphics, symbols and some text making them as accessible as possible for the residents. The profile includes important information e.g. What’s important to me, Things I like/dislike. These sections had been thoughtfully completed based on careful assessments of the resident’s behaviour and through observations of reactions to different situations. One person dislikes loud noises and open spaces, another enjoys old comedy films. St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 Page 10 The individual Daily Support Plans are sequential support plans from first thing in the morning through to bedtime. The plans state the person’s preferences and how they like to manage aspects of their daily routine and where and how support is best provided to maximise their dignity and independence. Risk assessments were comprehensive and covered all aspects of the resident’s lifestyle both in the home and out and about. From discussions with staff the risk assessments are used positively to ensure residents participate in all aspects of daily living at the home and pursue a variety of activities when out and about in the community. Further discussions with staff demonstrated their working knowledge of the individual daily support plans and this information was verified through reading the notes of two residents St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 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): 12 & 13 • Residents attend a range of Day Services, which offer opportunities to mix with their peers and develop further social and educational experiences. • All residents are engaged in activities that include accessing the local community on a regular basis. EVIDENCE: Evidence for these standards was obtained from discussions with staff and the specific records and assessments in the resident’ files. The residents have enjoyed a range of holidays this summer from a trip to France for some whilst others have stayed more locally in Dorset. Two residents went for a weekend to London and took part in different events including Proms in the Park. Holidays and trips are organised according to the resident’s interests, needs and preferences. Staff spoke confidently about the needs of residents and the type of holiday environment most suitable to meet their individual needs. Residents attend Day Services in Bridport and Sherborne and there was positive evidence in the resident’s records of multi-disciplinary work with staff St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 Page 12 ensuring a consistent approach in understanding and managing the needs of the residents. During the course of this inspection visit four residents returned home from Day services in Sherborne and another had spent the morning helping in a Shop in Bridport. Each resident has a Participation chart which allows staff to monitor residents desire to join in activities and serves as a further indication as to the resident’s preferences. St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 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): 18 & 19 • Personal and healthcare support is provided according to the resident’s assessed needs and preferences and is documented for all staff to read in both the daily support plans and in the comprehensive Clinical information section of their files. • The home’s system for assessing, reviewing and monitoring the healthcare needs of residents is good and ensures their healthcare needs are provided for including those with more complex needs. EVIDENCE: Resident’s care and health needs are clearly identified in their records. Their likes /dislikes are recorded regarding their preferences in their daily routines and how they like the support to manage their personal and healthcare needs. The home operates a system of designated keyworkers, which provides “ team support for each resident”. In practise this means each resident is linked with one qualified member of the staff team and possibly two other support workers. This team support provides consistency and continuity of support to service users. Discussions with staff again demonstrated a good understanding of the personal and healthcare needs of residents and it was evident other agencies had been appropriately referred to for specialist assessments, advice and support. St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 Page 14 A medication profile, OK health check, living assessment based on the resident’s general health needs, weight charts, medical visits, manual handling assessments and reviews were all working documents found in the resident’s files. St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed at this inspection. EVIDENCE: St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, & 26 • Residents live in a comfortable home that is suitably furnished to meet their needs and ensure as far as possible a safe environment for everyone living and working at 193 St Andrew’s Road. • There is sufficient communal space for residents to enjoy the shared facilities or find their own space. EVIDENCE: A partial tour of the premises was completed with a member of staff and since the last inspection considerable work has been completed. This includes the total refurbishment of the kitchen. A new non-slip floor covering has been laid in the conservatory, and both bathrooms. New floor covering for the lounge is currently on order. The lounge, dining room, conservatory and gardens are totally accessible however due to health and safety risks other parts of the building must remain locked. Each resident has specific risk assessments and consent forms completed indicating on their behalf that this is undertaken for personal safety however the situation and assessments remain under review. Unfortunately it has not been safe to hang pictures on the walls and therefore aspects of the home look a little stark however this is in the best interests of the residents and staff. St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 Page 17 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): None of these standards were assessed at this inspection. EVIDENCE: The staff training records were checked and demonstrated Dorset Residential Homes ongoing commitment to staff training both in ensuring all mandatory training is up to date and also professional and special interest training events. (The exception to the otherwise clear training information was the Fire Prevention training records please refer to NMS 42) St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 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): 42 • At the time of this unannounced inspection safe-working practices appeared to be satisfactory ensuring a safe environment for both residents and staff. EVIDENCE: Most of the records seen at this inspection were up to date and accurate however, the fire records need to be organised to clearly identify night and day staff and must be kept up to date. All staff on duty did state they had been involved in a fire drill within the last six weeks though the documentation to validate this was not located on the day of this inspection. Staff also stated that they all attend an annual fire Training Lecture which is undertaken with an Approved External Agent. The next one is booked for November 2005. St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 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 3 3 x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x 3 x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Andrews Road (193) Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x DS0000020420.V252898.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation Requirement Timescale for action 31/10/05 23(4)(d)(e) Up to date fire prevention training records must be available at all times and provide documented evidence of regular training and fire drills for all staff. (and residents) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Andrews Road (193) DS0000020420.V252898.R01.S.doc Version 5.0 Page 21 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.V252898.R01.S.doc Version 5.0 Page 22 - 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. 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