Inspection on 19/05/05 for 20 Edward Road - Leonard Cheshire Disability

This inspection was carried out on 19th May 2005.

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

20 Edward Road - Leonard... 24/07/06

20 Edward Road - Leonard... 09/12/05

20 Edward Road - Leonard... 31/01/05

20 Edward Road - Leonard... 02/08/04

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 20 Edward Road Dorchester Dorset DT1 2HL Lead Inspector Marion Hurley Unannounced 19 May 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. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 20 Edward Road Address Dorchester Dorset DT1 2HL 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 265097 01305 250138 dorchester@westleonard-cheshire.org.uk Leonard Cheshire Dorchester Homes Mrs Elaine Bernice Grant CRH PC - Care Home Only 3 Category(ies) of LD - Learning Disability (3) registration, with number of places PD - Physical Disability (3) 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 31st January 2005 Brief Description of the Service: 20 Edward Road is a care home providing personal care and accommodation to three adults who have a learning disability and additional physical disability. 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 Grant, who is based at the provider’s local office in Alexandra Road, Dorchester. The home is a bungalow that has been converted and extended. It is located in a quiet residential street, within walking distance of Dorchester 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. All service users have single bedrooms and share the communal lounge, kitchen and dining room. There is level access throughout the first floor, and to the front and rear doors. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 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. Edward 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 five hours, approximately two of which were spent at the home. In the course of this inspection both the Registered Manager and two members of the staff team were available. Three residents were at home but did not participate in the inspection. All records, documents and files were easily accessible on the day. 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? The staff have worked hard to maintain and ensure the service they provide is needs led in a domestic, relaxed and informal way. All residents have had routine audio and vision tests. The Registered Manager and staff have begun to discuss how to develop the existing Care/Service Plans into Person Centred Plans. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 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. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 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 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 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 at this unannounced inspection. One recommendation from the previous inspection remains within the timescale for completion and will be fully assessed at the next inspection. EVIDENCE: 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 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) 6,7,8 &9 Care Assessments and Plans are in use for each of the residents. Each plan incorporates risk assessments, which indicate where residents are particularly vulnerable and what action must be taken to safeguard each resident. • 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. The level of participation is very personal to each resident’s abilities and interests. EVIDENCE: Three residents were at home during the course of this inspection visit however, none were able to indicate their understanding of the assessment /care plan process. Each person has a support plan, which is a combination of care assessments, and plan. These documents contain a lot of relevant detail 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 support plans set out how their current needs are met but do not clearly identify short /long term goals for each person. Only a percentage of the documents had been reviewed. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 10 • • 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. All assessments/plans should be reviewed every six months to reflect any changing needs/abilities. The Registered Manager and staff need to consider ways to develop and produce a simple plan for each resident which through graphics and symbols may be recognisable to them and reflect their different activities. Observations of the two staff working with the three residents present during the visit very clearly indicated their understanding and excellent communication skills with the residents. They seemed relaxed in each other’s company. Several times a resident would lead one of the staff to what they wanted or needed. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 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, • • Residents pursue a variety of daytime occupations, which include attendance at day services, which provide stimulating and age appropriate activities with their peers. 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. EVIDENCE: At the time of this inspection all three residents were at home however, all the residents have varied weekly routines. Two residents attend Day Services on a part time basis and the third person participates in various occupations in and around the home or in the local community on a one to one basis. Evidence for these standards was obtained from reading the resident’s individual diaries, care plans and through discussion with the two staff on duty at the time of this inspection. A cookery session was planned for the afternoon which was starting with the residents choosing the type of cakes they wanted to make, shopping for the ingredients, baking and finally eating the cakes. The residents appeared to be 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 12 enthusiastic for all the different aspects of this activity. Trips and entertainment are organised sensitively according to the resident’s interests and abilities and include swimming, art therapy ,cart riding and boat trips. Staff discussed the benefits of such outings and trips describing some aspects as clearly therapeutic and it would be beneficial if this knowledge was included in the residents support plans / diaries. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 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 standard(s) 18, 19 & 20 • • Residents receive personal support based on their abilities, needs and personal preferences. This ensures staff deliver support, which is flexible, consistent and responsive to the residents needs. Medicines in the custody of the home must be handled according to the requirements of the Medicines Act 1968. EVIDENCE: Residents are not able to take control of their own healthcare needs, however there were clear records which indicated staff ensure residents health and well being is carefully monitored. Records of medication received, administered and leaving the home or disposed of were not found to be in sufficient detail to ensure a thorough a audit could be undertaken at any time. Each resident has a support plan which incorporates many aspects relating to their health and general well being. Records and medical charts showed that Health needs are monitored and any change in patterns or routines are recorded to ensure accurate discussion and information is exchanged with members of the Community Specialist Teams. Staff on duty stated they had a very positive working relationship with the Community Teams,G.P’s and District Nurses stating they felt well supported by all these professionals who were extremely helpful and understanding in their 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 14 management of the residents’ sometimes complex health and emotional needs. Moving and handling assessments should be regularly reviewed to meet the resident’s changing needs. 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. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 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 standard(s) 22 • The current group of residents would have great difficulty in understanding the concept of a complaint or concern. 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: Evidence to support this standard was obtained through discussion with both staff and the Registered Manager and from observing staff interact with the residents seen on the day of this inspection. The three residents all have different abilities each having developed their own method of communicating their pleasure or apprehension. Both the Registered Manager and members of staff explained their methods to ensure extreme behaviour is handled carefully without denying the resident any personal liberties. Staff have considerable intuitive knowledge and it would be advantageous for this to be recorded in the residents support plan. The plans contain some information about communication but when talking with the support staff their sensitivity and detail surpassed the written documents. No complaints or concerns have been raised since the last inspection. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 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 standard(s) 24 & 30 • • Edward Road 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 and reasonably comfortable for the residents but aspects of the premises are in need of redecoration and refurbishment EVIDENCE: A partial tour of the premises and garden was completed. Two bedrooms are on the ground floor and one on the first floor. The two ground floor rooms have been specially adapted and have aids and adaptations to meet the specific needs of the residents. The radiator in the dinning area was found to be extremely hot to the touch and whilst a temporary cover was in place this was not adequate to protect residents from either deliberately or accidentally touching this very hot surface. The Registered Manager advised that work to replace the radiators with new low surface radiators was pending. The bathroom needs to be modernised with safe fixtures and fittings rather than the current practice of removing the tops of taps when not in use. Efforts should be made to research an alternative method rather than physically removing the taps every time after use. If residents are at risk in the bathroom then this information should be identified in both the support plan 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 17 and risk assessment with strategies how to minimise the potential hazard. Staff work hard to maintain a homely and cheerful environment despite some residents not understanding the need to respect the fabric of the home. Residents would not be able to use locks on their bedroom doors this information should be identified on both the support plan and included in their individual risk assessments. 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”. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 18 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) 31,34 & 35 • Two staff files were read and each contained the required information to meet recruitment standards. Each file contained the employee’s specific job description, which clearly set out their tasks, and responsibilities, which are an integral part of ensuring the residents receive a quality service, which provides the support needed. 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: Two staff were working at the home during the course of this unannounced inspection visit. Both stated they felt well supported by the management and other members of the staff team. They explained that informal supervision and “back –up” was always available from senior staff whilst formal supervision was regularly conducted with their Manager. Notes of supervision sessions were checked. There is a training matrix which indicates when staff have received training and when refresher training for mandatory courses is due. This validated previous information received during the course of this inspection. The Training Co-ordinator who is based at the Leonard Cheshire Administrative Office in Dorchester ensures information is kept up to date; this is then passed to the Regional Office to be included in the Regional Training Matrix. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 19 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) 38 & 42 • • The Registered Manager is competent and experienced to run the home and is currently studying for NVQ level 4 in both management and care studies. Health and safety records examined demonstrated that most safe working practises were in place and implemented thereby protecting residents and promoting their well being. However, not all staff were found to be receiving fire prevention training within the prescribed timescales. EVIDENCE: The Registered Manager has created an open and inclusive atmosphere within Edward Road and on the day of this inspection visit the staff, manager, and residents were confident and happy in each other’s company. 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 of fire prevention, risk 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 20 assessments and safe working practises is with 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. At the time of this inspection not all staff were receiving fire prevention training every three months. However all other Fire safety Precautions and testing of equipment were being implemented. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 21 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 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 x x x Standard No 31 32 33 34 35 36 Score 3 x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 20 Edward Road Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 2 x D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 22 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 2 Regulation 14 Requirement Any restrictions & limitations placed on residents must be based on an assessment and discussed and agreed by the residents represenative & other professionals. & therefore this requirement is carried forward with anew timescale. All staff must receive appropriate training in physical intervention and restraint. At the time of this 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. The home must establish and mainatin a system for reviewing and monitoring the quality of care provided by the home and where possible invovling residents or their representatives. All staff must receive three monthly fire prevention training . At the time of this inspection this requirement was being addresed but not completed. Timescale for action 31 st October,20 05 2. 23 13 31 st October,20 05 3. 39 24 31 st October,20 05 4. 42 23 31 st October,20 05 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 23 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 user plans need to be written based on the principles of Person Centred Planning and should include a record of the residents short and long term goals and acheivements. Risk assessments should be reviewed regularly and provide details of who has been involved /consulted with during the assessment process. Risk assessments must reflect the individual residents abilties/needs and the hazards applicable to them and the plan of actions to minimize the hazards and 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. The home should ensure that furnishings,fittings, adaptations and equipment are good quality and are as unobtrusive and ordinary as is compatible with fulfilling their purpose. It is understood the bathroom is scheduled to be refurbished in 2005. 2. 9 3. 20 4. 24 5. 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 24 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 20 Edward Road D55 S26746 20 Edward Road V227790 190505 Stage 4.doc Version 1.30 Page 25 - 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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