CARE HOME ADULTS 18-65
Prince Of Wales Road (3) Dorchester Dorset DT1 1PW Lead Inspector
Marion Hurley Unannounced Inspection 14th February 2006 10:00 Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Prince Of Wales Road (3) Address Dorchester Dorset DT1 1PW 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 269208 01305 269208 Dorset Residential Homes Mrs Anna-Marie Gill Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23rd September 2005 Brief Description of the Service: 3 Prince of Wales Road is a care home registered to provide nursing care and accommodation for 8 learning disabled people who may also have physical disabilities and emotional and behavioural needs. The home is operated by Dorset Residential Homes, a registered charitable trust that operates a number of care homes in Dorset. The home is located in Dorchester within easy reach of the town centre. It is a large detached property that has been carefully extended and adapted to meet the needs of service users; the home does not stand out from neighbouring properties. There are 4 single bedrooms and 2 shared bedrooms for service users; on the ground floor there is a lounge, kitchen and dining room. The home has level access throughout the ground and 1st floor and there is also a passenger lift. There are bathrooms and toilets on both floors; the home also provides a range of equipment to meet the needs of people with disabilities. The home is staffed by a team of registered learning disability nurses and care staff who provide 24-hour care and support. Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 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. 3 Prince of Wales 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 seven hours, three of which were spent at the home with the Registered manager, Liaison Officer and staff. During the inspection records related to the specific standards assessed were checked. What the service does well:
The management and staff in the home provide an individual service to all the residents based on their assessed needs. Staff encourage and support each resident to lead as independent lifestyle as possible offering a wide and varied range of activities that the residents enjoy and find stimulating. The home has a comfortable homely feel and is decorated and furnished to a high standard providing the residents with a safe and friendly environment in which to live. The resident spoken with confirmed they were happy and felt involved in the day-to-day running of the home; they enjoyed the facilities and activities they pursued. Each resident has a support plan, which is detailed and tailored to their specific needs particularly relating to how much support and encouragement is needed by individual residents to maintain and develop their independence. The support plans are extremely well illustrated and good use of photographs and graphics backs up the written statements. The home has good links in the community and is able to access all amenities and facilities both for leisure and recreational purposes and for healthcare needs. The home has a stable staff team who are supported by the home’s manager. The management of the home encourage and support the staff to up date their skills and professional development and this enables the home to provide a consistent quality of life for all the residents. The home involves everyone in the running of the home, the residents, their family and the staff everyone is encouraged to make suggestions and equally to voice any concerns or problems they may have and it was evident from talking with and observing residents that they feel comfortable in discussing and expressing any issues they may have. Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were applicable at the time of this inspection visit. The group of residents living at this home have done so for over six years and there is no anticipated change to this family style group. EVIDENCE: Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 • Residents fully participate in the daily life of the home and staff offer and support residents to make as many decisions and choices as possible. EVIDENCE: Each resident is linked to a “keyworker group” and this group “formally “meet with the resident at least monthly. This provides an excellent forum for residents and staff to discuss how the resident is involved in the day-to-day decisions in the home. Some residents have limited verbal skills but it was evident from discussions with staff that this does not hinder the residents’ involvement in decision making within the home. Staff described how some residents could indicate their decisions through their body language, facial expressions and the use of pictures. Consulting residents and encouraging and enabling them all to participate in the life of the home is considered to be one of the core activities within the home. Two Support plans were read and comprehensively demonstrated the opportunities residents have in contributing and making decisions about their own lives. Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,& 17 • Residents are provided with opportunities for personal development and are supported to enjoy leisure activities of their choice. • Residents are provided with a healthy well balanced diet. EVIDENCE: Residents are encouraged to pursue their own interests and hobbies, which have been identified with them when compiling their personal support plans. All participation is recorded daily on the resident’s own Activity Chart and in their daily notes. Residents attend day services at Bridport or Sherborne four days a week and the fifth day is classified as “their day off”. Residents are encouraged to take part in a wide range of activities in the home from using the quiet sensory equipment to karaoke. Where possible residents are encouraged to take responsibility for when and what activity they want to pursue in the home. For residents, which find it more difficult to communicate their preferences staff through their observations and personal knowledge of
Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 11 residents feel confident to assess and judge if the resident enjoys and benefits from a particular activity. Maintaining family support and involvement of friends and relatives is fundamental to the home. Parents and families if they wish and if the resident agrees are very welcome to participate in the residents’ annual review of their Support Plan. The relaxed atmosphere in the home and the inclusive approach of staff actively encourages visiting. Visitors are invited to stay for meals and then join in any activity taking place on or off site. The manager has successfully recruited volunteer leisure companions who are linked with individual residents often going out and sharing a common interest /activity. A resident who was at home during the inspection visit described the different things they liked doing which varied from shopping to looking after animals and explained how they got to decide what they would do on “their day off”. The resident went through their own Support plan with the inspection and there were clear descriptions and action plans of the different activities they enjoyed and joined in. The resident was rightly proud of their individual support plan, which was a credit to them, and the staff that had help produce the working documents. Menus are planned with the residents weekly. Staff take turns in preparing the meals. Several of the residents enjoy one to one cookery sessions often making snacks for their lunch boxes or cakes that are then shared with others in the home. Meals are based on a healthy nutritious diet though once a week residents may choose exactly what they fancy. Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 • The systems for ensuring the safe handling and administration of the residents’ medication are thorough. EVIDENCE: Medication administration sheets (MAR sheets) were examined. DRH has comprehensive policies and procedures for the management of residents’ medication and it was clear from checking the records and storage that the procedures were being carefully followed and implemented at the home. Each resident has a medication profile and these were well written providing details of how and why the resident requires their prescribed medication and any possible known side effects of the drugs. It is recommended these profiles be reviewed annually. Drug orders are kept in a separate file and the number received into the home is signed off against the number ordered. The Registered Manager commented on how helpful their Pharmacist was for example they always set up in a separate cassette a resident’s medication for the period of planned leave from the home. The pharmacist undertakes an audit annually and there were no significant recommendations made at the time of the last one (06:12:05). Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 13 One person self medicates and is delighted to have achieved this responsibility following an intense period of careful training coupled with a comprehensive risk assessment. Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 14 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): 22 & 23 • The policies and procedures that are in place regarding complaints and adult protection aim to ensure residents feel listened to and they are protected from abuse, neglect and self-harm. EVIDENCE: There are clear and robust adult protection policies and procedures. All staff undertake training in the protection of vulnerable adults. In addition staff studying for NVQ’s have to successfully complete a component on the subject of Vulnerable Adults before achieving their final qualification. There is a detailed complaints policy, including details of how to contact CSCI. A record of complaints is maintained. There have been no complaints since the last inspection. Staff spoken with were clear about what to do to ensure that residents are kept safe and to ensure that all residents are actively listened to. Staff spoken with said they felt confident they would be able to identify any concerns from any of the residents whether these were expressed verbally or non-verbally or just through the residents own body language. Staff are constantly checking with the residents both individually and in their keyworker groups if life for the resident is going well and they feel safe and well looked after. Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 15 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 and met at the last inspection and were not assessed at this inspection visit. EVIDENCE: Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 16 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): 34 • Recruitment policies and procedures are comprehensive and implemented ensuring the safety of the residents. EVIDENCE: There have been no staff changes in the past two years. The home operates with a full compliment of staff. It is approved to supervise student nurse work placements. Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 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): 37 & 39 • The Registered Manager is qualified and experienced to ensure that both residents and staff benefit from a well run home. • There is an emphasis on review and development through resident and relatives’ feedback. EVIDENCE: The Registered Manager is committed to maintaining her own professional development and this commitment contributes to the efficient running of the home. The manager is proactive in the home having been involved in the development of the Support Plans. It was clear from residents’ comments and reactions from staff that everyone feels able to raise issues of concern and are confident these would be discussed and addressed. There are regular staff and resident meetings, which provide a forum to discuss and monitor the quality of services, facilities and care provided. The “responsible individual”/ representative for Dorset Residential Homes completes the monthly monitoring visits. (Regulation 26 reports). These are comprehensive and extremely useful and provide a good picture of life in the home.
Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 x STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X x LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 x 3 X 3 X X X x Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 19 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Prince Of Wales Road (3) DS0000020421.V279244.R01.S.doc Version 5.1 Page 20 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
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