Inspection on 09/12/05 for 20 Edward Road - Leonard Cheshire Disability

This inspection was carried out on 9th December 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 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

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

20 Edward Road - Leonard... 19/05/05

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 Edward Road (20) Dorchester Dorset DT1 2HL Lead Inspector Marion Hurley Unannounced Inspection 9th December 2005 11:30 Edward Road (20) DS0000026746.V266787.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 Edward Road (20) DS0000026746.V266787.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. Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Edward Road (20) Address Dorchester Dorset DT1 2HL 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) 01305 265097 01305 250138 Leonard Cheshire Care Home 3 Category(ies) of Learning disability (3), Physical disability (3) registration, with number of places Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th May 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 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. Edward Road (20) DS0000026746.V266787.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. 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; one and half were spent at Edward Road close. In the course of this inspection two members of the staff team and the Registered Manager were available and all the residents who live at the home. What the service does well: What has improved since the last inspection? What they could do better: The home must continue to improve the quality of risk assessments, which should reflect each resident’s abilities and needs and the associated hazards and specific risks to each individual. The risk assessments should not only be used to justify limiting certain actions but demonstrate how positive use of the risk assessments residents can enable the residents to expand their horizons and lifestyles even further. The refurbishment of the bathroom needs urgent attention. Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 Page 6 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. Edward Road (20) DS0000026746.V266787.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 Edward Road (20) DS0000026746.V266787.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 • Service Users would only be admitted based on an assessment of their needs ensuring the home would be able to meet the service user’s identified needs and have the appropriate staffing levels and facilities. EVIDENCE: Since the last inspection no new services users have been considered for Edward Road. The group of people living at this small family style home have done so for many years and a vacancy is not anticipated. In view of this the inspector discussed the principles of a prospective service user being considered for a placement with staff and it was clear from these discussions that their knowledge and understanding of good working practices would ensure any prospective service user’s needs would be fully identified through comprehensive assessments. Many of the prospective service users considered for the Cheshire Home Service have complex needs and very individual methods of communicating and in reality it might take months to complete a full assessment of the person’s needs, preferences and wishes. Records relating to the resident’s needs indicated the staff’s ability to seek advice and work as part of a multi agency network obtaining specialist assessments where appropriate. It is anticipated any prospective service user would benefit from this comprehensive approach. Prospective service users would always be involved and the admission process would be based on the individual’s ability to cope with the transition of moving into a new situation. Edward Road (20) DS0000026746.V266787.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): The key standards were not assessed having been met at the previous inspection. Please note a good practice recommendation from the previous report has been fully actioned and the records of one service use reflected the change in style of formulating the resident’s individual Plans which now are Person Centred and holistic providing the reader with a feel of the person’s wishes, abilities and needs. EVIDENCE: Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 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): 15,16 & 17 • Staff ensure residents are supported in maintaining contact with family members and in developing appropriate friendships. • Resident’s rights are respected and where possible independence and choice and freedom of movement are promoted within the home. • Meals are healthy and mealtimes flexible to suit residents lives. EVIDENCE: The evidence for these standards was obtained from discussion with staff and from reading the Individual Plans of one resident. There was evidence of regular liaison with relatives and family details and contact information was documented. Residents are helped to maintain contact /visit their family and friends. Visitors are always welcome at Edward Road. Residents are friends with other service users supported though the Cheshire Home services and also benefit from regularly meeting their peers at Social and Education Centres. One resident went on holiday with a friend from another local Cheshire Home and this worked very well. Another person visits regularly and all the residents at Edward Road enjoy this person’s company. Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 Page 11 The menu is planned a month in advance and whilst it does not show specific choices there is always an alternative available. Staff know the resident’s likes and dislikes and adjust the menu accordingly. Staff are keen to encourage healthy living and the menu was balanced and with a good variety of meals. Ample fresh fruit and juices are consumed daily. Residents are encouraged to help prepare their own meals and especially at breakfast they are encouraged to make decisions about what they want to eat. A record of all meals/food consumed whether at home or whilst out is recorded in each resident’s diary. Further records were noted of the temperatures of appliances, cleaning rota, and cooked food temperatures. Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 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): The key standards were not assessed having been met at the previous inspection. EVIDENCE: Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 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): 23 • • Adult Protection is appropriately and well addressed in staff training. There are both policies and good practice in place to help safe guard service users from potential abuse and harm. EVIDENCE: Cheshire Homes, Dorchester has clear policies and procedures and staff have a working understanding of the issues concerning the Protection of Vulnerable adults. Staff are provided with information in their induction programme about the key issues surrounding Adult Protection, and Whistle blowing and this is then followed up with further refresher courses. Staff are currently being nominated for a series of POVA training events some of which are self-directed refresher courses. The staff spoken with during the course of this inspection demonstrated a good understanding of the issues and were aware of their roles and responsibilities to ensure the residents are safeguarded at all times from potential abuse and harm. Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 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): The key standards were assessed at the last inspection. However, a good practice recommendation for NMS 24 remains and is now carried forward and becomes a requirement. EVIDENCE: The bathroom remains in need of urgent refurbishment. Tiles are off the wall, one of the pipes has a leak and there is a general smell and evidence of damp in the room. Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 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 & 34 • Residents are protected by the employment procedures and the staff training programme, which is comprehensive and covers all aspects of the statutory training. EVIDENCE: Members of the staff team each talked confidently about the needs and preferences and wishes of the different residents. They each had clear insight into the different styles of communicating each resident uses. Brief observations made on the day of the inspection indicated how well staff and residents get on and there appeared to be a positive and open relationship. Residents were unable to verbally confirm these indications but there is no question that through their individual communication and specific behaviour each would clearly indicate any negative feelings they might have towards staff - none were observed. All staff files are retained at Cheshire Homes main Dorchester Office and three files were checked when visiting these administrative offices. Each file contained the required statutory checks and references. Both POVA first and an Enhanced CRBs check had been received plus two references. Identification and a photograph were found in each file along with completed interview notes, “letter of offer of employment”, terms and conditions/contract. A useful checklist was at the front of each file and had been completed in each case. An induction/training checklist was found completed in two out of the three Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 Page 16 files and those completed confirmed which policies and procedures had been provided to the new recruit. Staff confirmed their induction training, which linked with the LDAF induction, and foundation training. Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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 & 42 • A quality assurance system needs to be implemented which means residents and or their representatives can be confident their views underpin the homes development. • Health & safety checks are adequate and these contribute to safe working practices to protect residents and staff living and working at the home. EVIDENCE: The responsibility for checking the health and safety equipment and servicing records is with the maintenance employee who is based at the Cheshire Homes Administrative Offices, Dorchester. Each home has a generic work base file containing risk assessment and these are reviewed. Other documents relating to individual staff fire prevention training are collated at the Administrative offices and kept with other training records in individual training files. Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 Page 18 An observation made at the last inspection referred to the temperature of the radiator in the dinning room, which at the time was found to be very hot. This has subsequently been reduced. However, the risk assessment for this radiator was originally completed in 8:07:03 which read “ambulant service user noted to stand over radiator, best known practice to reduce this risk would be to install a low surface temperature radiator”. Since 2003 the risk assessment has been reviewed and verified by the entry of dates in the file but there is no evidence this good practice to replace the radiator as recommended by Cheshire Home staff in 2003 is to be implemented. The “responsible individual” who represents Cheshire Homes completes the monthly monitoring visits, Regulation 26 and these reports are comprehensive and extremely useful and practical in providing on going information. Staff work well with other agencies and this was documented in Individual Service plans. However, there was no evidence that the views of significant stakeholders are canvassed when reviewing and planning the on going development of the Services and therefore the requirement made at the last inspection with reference for NMS 39 is carried forward. Edward Road (20) DS0000026746.V266787.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 x x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Edward Road (20) Score x x x x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x DS0000026746.V266787.R01.S.doc Version 5.0 Page 20 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. 1 Standard YA24 Regulation 23 (2)(b) Requirement 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 was understood the bathroom was scheduled to be refurbished in 2005. The home must establish and maintain a system for reviewing and monitoring the quality of care provided by the home and where possible involving residents or their representatives. Timescale for action 31/03/06 1 YA39 24 31/03/06 Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 Page 21 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 YA9 Good Practice Recommendations 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 abilities/needs and the hazards applicable to them and the plan of actions to minimize the hazards and risks. Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 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 Edward Road (20) DS0000026746.V266787.R01.S.doc Version 5.0 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. 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