Inspection on 27/01/06 for 1a Daubeney Gate

This inspection was carried out on 27th January 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 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

1a Daubeney Gate 20/02/07

1a Daubeney Gate 29/12/05

1a Daubeney Gate 11/01/05

1a Daubeney Gate 10/06/04

1a Daubeney Gate 19/02/04

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

CARE HOME ADULTS 18-65 Daubeney Gate (1a) Shenley Church End Milton Keynes Bucks MK5 6EH Lead Inspector Chris Schwarz Unannounced Inspection 27th January 2006 07:55 Daubeney Gate (1a) DS0000015054.V281772.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 Daubeney Gate (1a) DS0000015054.V281772.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. Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Daubeney Gate (1a) Address Shenley Church End Milton Keynes Bucks MK5 6EH 01908 505245 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.macintyrecharity.org MacIntyre Care Mrs Sally Charrington Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th December 2005 Brief Description of the Service: 1A Daubeney Gate is a purpose built care home for adults with learning disabilities located in a residential part of Shenley Church End, Milton Keynes. The home is close to local shops and is a short drive from the city centre and public transport networks are close to the home. The property is owned and staffed by MacIntyre Care Services. Each service user has a single bedroom and these are decorated and arranged to reflect different interests and tastes. The home has a good sized lounge with patio doors leading to a large enclosed garden. There is a separate dining room next to the kitchen and laundry and staff sleeping in and office facilities on the ground floor. The home has ample toilet and bathroom facilities. Service users have a cat called Jessie. Service users of both sexes were being cared for at the time of the inspection, with a range of personal care needs. Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday and lasted from 7.55 am until 10.40 am. It consisted of discussion with staff and service users and observation of the morning routine and opportunity to sit with service users during breakfast. The two requirements and recommendation number one had only recently been made and are included in the report as a reminder. Three recommendations have been made as a result of this visit. The manager was on duty for the latter part of the inspection and was given feedback about the visit, which was positive, reflecting considerable change at the home. What the service does well: What has improved since the last inspection? What they could do better: Use of plastic drinking beakers should stop to ensure that service users have appropriate crockery provided, unless identified within their care plan. Individual daily reports should be used rather than a collective book, to promote best practice and preserve confidentiality. Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 6 It is recommended that a copy of the quality assurance audit be forwarded to the Commission, for reference. 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. Daubeney Gate (1a) DS0000015054.V281772.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 Daubeney Gate (1a) DS0000015054.V281772.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): EVIDENCE: None of the standards in this section were assessed on this occasion. Daubeney Gate (1a) DS0000015054.V281772.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): EVIDENCE: None of the standards in this section were assessed on this occasion. Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 10 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 and 16 Appropriate activities are arranged for service users, providing them with variety, stimulation and involvement within the community. Service users’ rights and responsibilities are recognised in order that they have fulfilment and choice in their lives. EVIDENCE: Each person living at the home has a day service placement during the week with staff providing transport in the home’s vehicle. Discussion with service users and reading of daily report notes provided evidence of service users using the local community and having involvement in a range of leisure and recreational pursuits. These included a birthday party arranged for one of the service users that night, having a meal at Pizza Hut, going to MacDonald’s, coffee and cake at Morrison’s, seeing families, listening to music, watching videos and DVDs and going out to the pub. Two of the service users have been attending an evening cookery class and service user holidays had taken place last year. Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 11 Records showed that service users are encouraged to assist with their laundry and some were observed making drinks and snacks during the morning and clearing away afterwards. The morning routine was relaxed and unrushed with evidence of staff offering service users choice of breakfast foods and a choice of which staff assisted them with personal care. It was observed that two of the service users were offered drinks prepared in plastic beakers by staff. There was nothing within the service users’ care plans to identify a recognised need for plastic beakers and is recommended that the use of china crockery be used instead. Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 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 the following standard(s): 20 Medication is well managed at the home, ensuring that service users receive the drugs they require to keep them healthy and well. EVIDENCE: The medication cabinet is located within the office and was locked when not in use with the key securely held. Medication administration records were in good order with signatures alongside prescribed dose times and each person was offered their medication at a suitable time within their morning routine. Each person’s records contained information on which drugs they were prescribed, what they are for and known side effects. The date of opening was added to a pack of eye drops and all medications were within their use by dates. Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 13 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): EVIDENCE: None of the standards in this section were assessed on this occasion. Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 14 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): EVIDENCE: None of the standards in this section were assessed on this occasion. Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 15 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 Service users are cared for by a competent and effective staff team, ensuring that they have consistency and that their care needs are met. EVIDENCE: The home was fully staffed at the time of the inspection. Staff were either at the point of undertaking National Vocational Qualification training or were involved with the certificate for working with people with a learning disability. Interaction between staff and service users was appropriate, there were sufficient staff on duty during the morning and they demonstrated knowledge of service users’ needs. Use of humour was appropriately used to defuse a service user who had become agitated. Staff reported that the incidence of challenging episodes had decreased in recent months. Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 16 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): 39 Monitoring and review processes are in place within the organisation to ensure that service users receive the care they require. EVIDENCE: The provider carries out monitoring visits to the home to evaluate quality of care and copies of the reports of these visits were available within the office. A quality assurance audit had been carried out within the last year although there was no report of the findings available at the home to refer to. The overall standard of record keeping was not inspected in sufficient detail to be able to assess standard 41 adequately. However, during the course of the inspection it was observed that staff have one bound book in which they keep daily reports of service users’ well-being. It is recommended that individual daily reports be used rather than a collective book, to promote best practice and preserve confidentiality if other agencies such as Social Services or health care workers need to refer to the home’s records for one person’s care. Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 17 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 x 23 x ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 3 33 x 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x x x x x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 x 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 3 x x x 3 x x x x Daubeney Gate (1a) DS0000015054.V281772.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? N/a 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 YA6 Regulation 15 Timescale for action The person centred planning 30/04/06 documentation for care plans must be completed for all service users within 4 months of this inspection. All new staff to receive fire 29/12/05 awareness training within 6-8 weeks of employment in line with the health and safety training provided during the induction process for the organisation. Requirement 2. YA42 23 (4) 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 YA23 Good Practice Recommendations The work currently taking place to provide a copy of vulnerable adult information in a service user-friendly format is completed as a priority. A copy of the quality assurance audit report to be DS0000015054.V281772.R01.S.doc Version 5.1 Page 19 2. YA39 Daubeney Gate (1a) 3. YA17 forwarded to the Commission. Use of plastic drinking beakers should stop to ensure that service users have appropriate crockery provided, unless identified within their care plan. Individual daily reports should be used rather than a collective book, to promote best practice and preserve confidentiality. 4. 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