Inspection on 01/09/05 for 21 Dimmingsdale Bank

This inspection was carried out on 1st September 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 but made no statutory requirements on the home.

Other inspections for this house

21 Dimmingsdale Bank 21/08/08

21 Dimmingsdale Bank 13/09/07

21 Dimmingsdale Bank 19/07/06

21 Dimmingsdale Bank 19/01/06

21 Dimmingsdale Bank 11/03/05

21 Dimmingsdale Bank 12/10/04

21 Dimmingsdale Bank 26/03/04

21 Dimmingsdale Bank 07/08/03

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Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 21 Dimmingsdale Bank Woodgate Valley Birmingham West Midlands B32 1ST Lead Inspector Sarah Bennett Announced 1 September 2005 st 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. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 21 Dimmingsdale Bank Address Woodgate Valley , Birmingham B32 1ST 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) 0121 422 7500 0121 422 7500 Trident Housing Association Vacant Care Home 7 Category(ies) of Learning Disability, Physical Disability - (7) registration, with number of places 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years Date of last inspection 11th March 2005 Brief Description of the Service: Dimmingsdale Bank is a purpose built home for seven people who have a learning and additional physical disability. It was first registered in 1995. It is situated in a residential area on the south side of the city known as Woodgate Valley. It is within easy reach of local shops, public transport and local amenities.The property comprises of three linked houses, set out with a pleasing frontage of small areas of shrubs and spacious off road parking. The facilities include a large open plan communal area, which is utilised as a combined lounge and dining room. There is a main kitchen, and five bedrooms, all with en suite facilities, which can be accesssed directly from the combined lounge/dining area. The office, sleep-in accommodation, laundry and a further two bedrooms are loacted on the first floor accessed via a stair lift. To the rear of the property there is a cushioned or astro turf patio with flower pots, surrounded by a raised lawn and shrubbery. Due to the gradient of the lawn service users are not able to access it. Wheelchair access into the house and out to the rear garden is evident . The ground floor facilities are fully accessible. However, the first floor accommodation can only be utilised by those who are able to use a stair lift. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over eight hours. Seven service users and four staff were spoken to. The Area Manager and the previous care manager visited the home and were spoken to. Care, staff and health and safety records were looked at. Two service users records were sampled. A tour of the premises took place. Six service users, three relatives and two professionals involved in the care of service users completed comment cards sent to the home before the inspection. The previous manager completed the pre-inspection questionnaire. Margaret Wyre (ex by ex) and her supporter from Sandwell People First were there for part of the inspection. As a service user Margaret has an expert opinion on what it is like to receive services for people who have a learning disability. Margaret’s comments are included throughout this report where she will be referred to as ‘ex by ex’. The ex by ex said: “I found it difficult to understand what many of the residents were saying to me, I found this really frustrating. As it was dinnertime staff seemed really busy and I did not like to ask if they could assist me in communicating with people. I would like to have found out more”. What the service does well: What has improved since the last inspection? Relatives said: “There are too many agency staff and I don’t know them”. The Area Manager said that all staff vacancies have now been filled and staff who were off sick have now returned so this situation should be resolved. Staff have received training in first aid, food hygiene and health and safety so enabling them to ensure that service users are safe. Staff have received training in epilepsy so that they can meet the individual needs of service users. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 6 The fire risk assessment and manual handling risk assessments have been reviewed ensuring that the risks to service users are minimised. A new manager has been appointed to work at the home and will start once the required checks have been done. The emergency lighting is tested monthly to make sure that it is working. 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. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 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 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 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) 2, 5 Prospective service users individual aspirations and needs are assessed to make sure that they can be met at the home. Each service user has an individual written contract so they are informed of the terms and conditions of their stay at the home. EVIDENCE: Service users records included an assessment that had been completed prior to their admission to the home. This covered a full and comprehensive list of areas. It was completed by the manager when visiting the service user at their previous home. Service users records included individual contracts and a Licence Agreement. The contract included the terms and conditions of the service users stay at the home. It had been signed and dated by the service user or their representative and the manager. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 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 The arrangements for service users care plans are inadequate and incomplete. Therefore, staff will not fully know service users needs, goals and aspirations and be able to support them appropriately. Service users are not consulted on appropriately in all aspects of life in the home. The arrangements for supporting service users to take risks as part of an independent lifestyle are not adequate and could potentially place them at risk. EVIDENCE: Staff said that they are involved in developing service users care plans and risk assessments. Each service user has an allocated key worker. One of the service users records included a care plan that was dated May 2004 and there was no evidence that it had been reviewed. The other service users records sampled did not include a care plan. However, the minutes of their care plan review meeting were available. This indicates that the service user does have a care plan, which must be available for all staff to follow. Documentation for ‘Essential Life Plans’ was in place but little of this had been completed. Staff said that this was due to the change of managers. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 10 The ex by ex said: “I asked the service users if they had a care plan and if they had helped in creating it. The service users did not seem to understand what I was saying but a member of staff said they all have a care plan. I asked the staff member if the service users have an input in their care plan. I was quite confused with her response, I got the impression they did not have any input but not completely sure. If people are not involved this needs to change”. Service users meeting minutes showed that these are held regularly. Recently these have also been recorded on audio tape so that they are accessible to service users. They had discussed holidays, activities, inspections and the new manager. Service users records showed that they attend meetings. The Area Manager said that no service users have advocates although staff have tried to access the advocacy services but they are not available. Staff asked service users if they would like quiche, chips and beans for their evening meal. A choice of meal was not offered. Pictorial boards for the menu for the day and the staff on duty are provided in the lounge so that service users can see what food is available and what staff are on duty. The previous days menu and rota was on the board. The ex by ex said: “I felt the service users did not get much choice in what they ate and possibly don’t really get the opportunity to go shopping for food either. They had a board on the wall which said what was for meals that day, this shows people are not given individuals choices, unless everyone had decided they wanted the same?” Service users records included Waterlow (pressure area) assessments. For the records sampled these had been assessed as being at risk of developing a pressure sore but no care plan or risk assessment was in place to state how the risk will be minimised. The Area Manager said that these service users are not at risk. Individual risk assessments are in place for service users. These state how the risk to service users using the kitchen, falling, fire, mobility, using the bath/shower, using the chair lift and falling down stairs are minimised. One service user was observed twice putting plastic in their mouth. Other service users alerted a member of staff to this. Staff responded immediately and appropriately. However, a risk assessment was not in place stating how to minimise the risks of harm to the service user. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 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) 13, 14, 15, 17 Arrangements are in place so that people living at the home experience a meaningful lifestyle. Service users are generally offered a variety of food and enjoy their meals. Not all service users appear to enjoy mealtimes. EVIDENCE: Some service users said they had been bowling on the morning of this inspection. Service users got out their many photographs of leisure and social activities that they had taken part in. These included photographs of birthday parties and a 70’s night that service users went to in fancy dress. At the 70’s night money was raised for the service users. They chose to spend it on a day trip to London where they went on the London Eye. Service users spoke about this day and photographs were seen. Two service users went out for lunch supported by staff. Service users have been on holiday to Wales this year supported by staff and said that they had a good time. The ex by ex said: “The service users all go on holiday together. I’m not sure who chooses where they go but they have recently been to Wales this year. Do service users all want to go on holiday together? Is it possible to go with people they may choose to go with, instead 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 12 of having to go in such a big group? Service users may not all want the same activities or go sight seeing as the others. I feel it needs to be more individualised”. Some service users attend day centres. Some service users access college courses from the day centre. A member of staff is employed to work at the home with two service users who do not have formal day care provision. They said that they support service users to go to art classes, shopping, swimming, museums, art galleries, bowling, cinema, the pub and anywhere else they wish to go. Service users records stated that service users go to the cinema, shopping, bowling, Botanical Gardens, Safari Park and discos. Inside the home service users listen to music, watch TV, read magazines, do art activities and play games. One service user said that they buy the newspaper of their choice every Sunday. The ex by ex said: “I was able to find out some of the service users enjoy going bowling. Many of them enjoy watching TV, programmes like the ‘Weakest Link’ and ‘Heartbeat’. I did find it upsetting when I was told many of the service users go to bed between 8.30pm and 9pm. This is far too early, I asked why this happens. I was told because some people need support to go to bed the day staff need to help people into to bed before they finish work. I find this terrible, people have to go to bed early simply because of staff shifts”. The inspection finished at 9.05pm, at this time there were no service users in bed however some service users were being assisted to get ready to go to bed. One service user said earlier on in the evening that they wanted to have an ‘early night’ but was not in bed at the end of the inspection. The home has a vehicle that service users use to access the community. Service users spoke about visiting their friend who used to live at the home the next day. The ex by ex said: “I did find out that tomorrow the service users are going to Wolverhampton to visit someone who they used to live with. I thought this was really good that service users have been able to keep contact with friends and visit them”. Service users said that their relatives visit them and they visit their relatives and sometimes stay overnight. Service users and staff said that service users go shopping to supermarkets for food supported by staff and this was observed. Staff were writing the shopping list with service users. One service user was asked if they would like food appropriate to their cultural background. Records of food provided to service users are kept as part of their daily records. Menus were sent before the inspection with the pre-inspection questionnaire. These showed that a variety of food is offered including culturally appropriate foods. These indicated that a variety of food is offered. Staff sat to support service users with their evening meal. A jug of cold drink, condiments and sauces were provided. Fresh fruit and vegetables and adequate food was available. Staff shouted across the open plan communal room to service users that dinner was ready. The ex by ex said: “We arrived when they were about to have dinner and it looked like the staff members cook and serve the meals to the service users. The staff shouted through the house at one service user saying to put his book away and his dinner was ready which made me feel 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 13 uncomfortable. People should not be shouted at through their own home and told what to do”. The ex by ex said: “During dinner when all service users sat round together it was very noisy. Some service users did seem happy but I couldn’t help feeling that if I were sat with so many people for my dinner the noise level would be too much. Some of the service users I felt did look uncomfortable eating with all the noise. Are people happy eating together? A question I did not get an answer for unfortunately”. All service users sat together and the dining table is not suitable for all to sit at the table. One service user sat to the side of the table using the tray on their wheelchair as a table. It was noisy however, staff were asking service users what they had done during the day and some service users had a lot to talk about. One resident became upset at the table and staff assisted them to go to their bedroom, where they calmed down. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 14 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 It is not clear how service users prefer to receive personal support. The arrangements for meeting service users health and personal care fail to ensure service users needs. The arrangements for the management of the medication are not adequate to protect service users. EVIDENCE: Service users records included manual handling assessments with guidelines for staff on how to support service users with mobility so that the risks of injury are minimised. Two service users bedrooms are on the first floor accessed by a chair lift. An intercom system is in place which service users press when they need assistance from staff. Staff responded promptly to the requests from service users. Care plans were not available for all service users so it is not clear how staff are to support service users with their personal care. Staff offered service users drinks throughout the inspection. Service users were dressed appropriately to their age, the weather and the activities they were doing. All service users are registered with a local GP. Service users have regular check ups with the dentist and optician. Service users records indicated that where appropriate health professionals are involved in the care of service 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 15 users. These include community nurses, psychologist, neurologist, physiotherapist, Where appropriate exercise programmes are written for individuals by physiotherapists and staff support the service user to follow these. The documentation for Health Action Plans in line with ‘Valuing People’ was in place for each service user. However, these were blank. Boots supply the medication using the monitored dosage system. Medication is stored in a locked cabinet. Staff are assessed by the manager as competent before they can give medication to service users. Two members of staff had recently made an error in giving medication so it had been agreed that they would not give medication until they had received further support and training and were reassessed. One of these members of staff was observed giving medication to a service user. Two members of staff give out medication to minimise the risk of errors occurring. All staff have received training from Boots in giving medication. At the front of each service users medication administration record (MAR) there is a photograph of the service user. Guidelines are in place for all as required (PRN) medication. All MAR up to the date had been signed and the monitored dosage system cross-referenced with the MAR. Therefore indicating that medication had been given as prescribed. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 16 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, 23 The arrangements for making complaints are adequate to ensure that service users views are listened to and acted on. Arrangements for protecting service users from abuse are not adequate and could compromise their safety and well - being. EVIDENCE: A complaints procedure is in place and is produced using pictures, making it accessible for service users. A copy of the complaints procedure is included in service users records and displayed in the hall. A record of complaints is kept. Two service users have made complaints, one of these was not upheld and one was upheld. These have been fully investigated, appropriate action has been taken and the service user has been informed of the outcome. Relatives said that they are aware of the homes complaints procedure. The organisation has an adult protection policy that is in line with Birmingham Multi- Agency Guidelines on the Protection of Vulnerable Adults. A copy of the multi-agency guidelines was available in the home. Three staff received training in the prevention of abuse in March 2005. None of the other staff have yet received this training. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 17 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, 26, 27, 28, 29, 30 Whilst the home has a number of comfortable and homely features the home does lack space and facilities for some of the service users. EVIDENCE: The open plan lounge and dining room is well furnished and decorated. Adequate seating is provided. The dining table is not high enough for some service users to sit at in their adapted wheelchairs. The previous manager said that they have tried to find a table that all service users can access. However, this has proved difficult as the average dining table is not high enough and if it was too high other service users may have difficulty. One service user sat to the side of the dining table to eat their meal using the tray on their wheelchair. In one of the service users bedrooms there was an offensive odour of urine, which was also present in the lounge near to the service users bedroom. Staff said that the lounge carpet had been cleaned a few days before. All service users have an en suite shower or bathroom depending on their individual needs. Appropriate aids and adaptations to the individual are provided. Service users bedrooms contain many personal possessions and are decorated according to individual tastes and interests. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 18 As raised in previous inspection reports, the home has been well planned for people who have a disability, but it lacks communal space. As the home is registered for people who have a physical disability it is disappointing that a vertical passenger lift is not provided, to facilitate access throughout the home. The addition of a conservatory would greatly enhance the opportunity for service users to receive visitors in private, without having to use their bedrooms. All areas of the home were clean. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 19 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) 33, 34, 35, 36 The arrangements for staffing, their development and support are generally adequate to meet the needs of service users. EVIDENCE: The Area Manager said there are no staffing vacancies at the home. Agency staff are used only to cover when permanent staff are off sick or on holiday. An agency member of staff was on duty on the late shift. They said they had worked at the home regularly for several months and showed that they knew the service users well. Rotas indicated that during the day there are three staff on an early shift and three staff on a late shift. In addition to this there is a day care facilitator for two residents. Some residents were on holiday from the day centre and extra staffing had been provided during the day. During the night there is one member of waking night staff and one staff sleeping-in on the premises. Minutes of staff meetings showed that these are held regularly. Staff had discussed the needs of service users, health action plans, service users holidays and changes to the staff terms and conditions. Staff records sampled included completed application forms, proof of identity, two written references, evidence that a Criminal Record Bureau checks had 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 20 been undertaken and evidence that the member of staff is physically/mentally fit to do the job they are employed to do. The ex by ex said: “The home is currently looking for a new manager and one service user will be interviewing potential people. This is really good to see a service user getting involved in the interviewing process, a must for service users choosing who comes into their home. Would it be possible for other service users to be involved?” Staff said and training records indicated that staff have received training in manual handling, health and safety, first aid, food hygiene, sign language, epilepsy and NVQ level 2 in care. The previous manager said that they are continuing to do annual appraisals for staff and some supervision sessions, until the new manager is in post and inducted into their new role. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 21 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) 37, 42 Currently, the arrangements for managing the home are not adequate to ensure that service users benefit from a well run home. The arrangements for promoting and protecting the health, safety and welfare of service users are generally adequate. EVIDENCE: The previous acting manager has been promoted to Area Manager for the organisation in Shropshire. The Area Manager said that a new manager has been recruited. It is hoped that they will start working at the home by the end of the month. A fire officer from West Midlands Fire Service visited the home on 4th August 2005. They left a report with three requirements. The Area Manager said that two of these requirements have been met. One requirement is outstanding but the Area Manager said that this had been reported to the maintenance department. Fire records showed that an engineer serviced the fire alarm in July 2005. Regular fire drills take place to make sure that staff and service users are aware of the procedure to follow in case of fire. Staff test the fire 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 22 alarm and the emergency lighting regularly to make sure that they are working. Staff last received training in fire safety in May 2004. Risk assessments for the premises were seen and had last been reviewed and updated where necessary in August 2005. The home has a vehicle that is used by service users to access the community. A current MOT certificate for the vehicle was seen. The vehicle insurance certificate seen expired in May 2004. A current certificate of employers liability insurance was displayed in the office. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 23 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 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 2 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 2 3 2 2 3 Standard No 11 12 13 14 15 16 17 x x 3 3 3 x 2 Standard No 31 32 33 34 35 36 Score x x 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 21 Dimmingsdale Bank Score 2 2 2 x Standard No 37 38 39 40 41 42 43 Score 1 x x x x 2 x Version 1.40 Page 24 E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Yes 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 6 Regulation 15 (1) (2) Requirement All service users must have a current care plan. There must be risk assessments in place for all risks to individual service users. All service users pressure area assessments must be reviewed. Where they are assessed at being at risk of developing a pressure sore a care plan and risk assessment must be in place to ensure the risks are minimised. A suitable dining table must be provided as access for some of the service users who use a wheelchair is problematic. (Previous timescale of 30th April 2005 not met). Each service user must have a Health Action Plan in line with Valuing People. Only staff assessed as competent to administer medication to service users must do so. Timescale for action 31st October 2005 & ongoing 31st October 2005 & ongoing 31st October 2005 & ongoing 2. 9, 42 13 (4) (a, b, c) 12 (1) (a), 13 (4) ( c), 15 (1) 3. 9, 18 4. 17, 29 23 (2) (n) 31st December 2005 5. 19 12 (1) (a) 6. 20 13 (2) (4) ( c) 31st December 2005 & ongoing Immediate & ongoing 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 25 7. 26 16 (2) (k) 8. 35, 23 The offensive odour in one service users bedroom must be addressed.(Previous timescale of 30th April 2005 not met). 18 (1) ( c) All staff must receive training in adult protection, disability awareness and race equality. A registered manager application must be submitted to the CSCI. All staff must receive regular training in fire safety. A copy of the current vehicle insurance certificate must be sent to the CSCI. The hole in the wall in the ground floor lounge area must be repaired using fire resisting materials as stated in the fire officers report. 9. 10. 37 42, 35 8 (1) (a, b) 18 (1) (a, c), 23 (4) (a, d) 13 (4) (a, b, c) 23 (4) (a) 11. 12. 42 42 30th September 2005 & ongoing 31st January 2006 & ongoing 31st December 2005 31st October 2005 & ongoing 30th September 2005 30th September 2005 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. 2. 3. 4. Refer to Standard 6 7, 8 8, 17, 33 28 Good Practice Recommendations Each service user or their representative where appropriate should be involved in developing their care plan. Each service user should be given informed choices in their day-to-day lives. The pictorial board should be used daily so that service users know what there is to eat and what staff are on duty. The organisation should review the communal space for service users and the lack of a private area for service users to meet relatives/ friends other than their bedrooms. 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 21 Dimmingsdale Bank E54_S16927_DimmingsdaleBank_V239576_010905AI stage 4.doc Version 1.40 Page 27 - 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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