Inspection on 13/03/07 for 44 Dexter Close

This inspection was carried out on 13th March 2007.

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

44 Dexter Close 09/03/09

44 Dexter Close 20/02/06

44 Dexter Close 11/07/05

44 Dexter Close 22/11/04

44 Dexter Close 06/04/04

Similar services:

Coopers Mill Ltd

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Upaya Ananda

Newton Court (1-2)

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Pemdale

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

CARE HOME ADULTS 18-65 Dexter Close (44) 44 Dexter Close Grays Essex RM17 5AU Lead Inspector Ms Diane Roberts Unannounced Inspection 13th March 2007 10:00 Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 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 Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 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. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dexter Close (44) Address 44 Dexter Close Grays Essex RM17 5AU 01375 396497 01708 851133 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) South Essex Special Needs Housing Association Ltd Mrs Joan Sylvia Day Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th February 2006 Brief Description of the Service: 44 Dexter Close provides care and accommodation for two adults with a learning disability. The home is managed by South Essex Special Needs Housing Association (SESNHA). The home is a three bedroomed house situated in a quiet cul-de-sac in Grays. It has a small enclosed rear garden. The shops in Grays are 10 minutes walk away. Local amenities are available. The home offers 24 hour care and aims to achieve a small family like environment. SESNHA have another small home nearby which also accommodates two residents. The two homes have the same registered manager, share some staff and maintain close links. The current fees are from £677.00 - £987.00, dependant upon need. A service user guide is available in different formats. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 2 and half hours and was carried out as part of the annual inspection programme for this home. The responsible individual, registered manager and deputy manager were available throughout the inspection. The home is currently full. The inspection focused upon all of the key standards. A partial tour of the premises was undertaken. Evidence was also taken from the Pre Inspection Questionnaire completed by the home and submitted to the CSCI. One of the residents was away from the home at the time of the inspection. It was possible to meet the other resident. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 6 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 Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents are fully assessed prior to admission, to ensure that their needs will be met. EVIDENCE: There have been no new admissions since the last inspection. The Manager has a system in place for pre-admission assessment and would go out and visit the prospective resident. Prospective residents are encouraged to come and stay at the home for periods of time as its is important, in such a small home that the two residents get on well and to help ensure that staff are able to meet their needs. The periods of time stayed would depend upon the resident and their needs, behaviour and abilities. The home has a service user guide and these are pictorial and were seen in residents’ rooms. Current admission have been previously inspected and found to be satisfactory. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning system reflects residents needs and show that they are encouraged to make choices and be independent. EVIDENCE: The care plans of both the residents living at the home were reviewed. Care plans were seen to be detailed and gave clear instructions to staff regarding meeting residents needs. Residents’ preferences were detailed throughout the care plans and their choices with regard to daily routines. Records showed that care plans are kept under review and placement reviews have been held in the past, which show a general improvement in individual resident’s overall abilities and confidence. Where appropriate, staff have used a pictorial system for the care plan, to help with resident involvement in the care planning process. It is recommended that the team develop person centred care planning further, to help with resident involvement in the care planning process. This was discussed. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 9 As part of the care plan, risk assessments are completed for a range of subjects on an individual basis for each resident’s dependant upon need. These evidence that independence is being promoted within a supportive environment. Although staff report that these have been reviewed, no documentary evidence was available and this was discussed. Daily notes are maintained to a satisfactory standard and reflect the care provided and the residents’ wellbeing. Residents have access to independent advocates as appropriate to their needs. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to undertake a range of activities linked to their own personal objectives. EVIDENCE: The abilities of the residents at the home vary greatly. Staff have identified individual activities for both residents which will help them develop personally, gain confidence and self worth. Activities range of daily living tasks such as laundry, food shopping and cooking to social activities such as swimming, library visits, social clubs, eating out, trips out etc. From records and discussion, it is clear that staff are aware of residents individual needs and abilities and are tailoring activities to suit them. Residents’ daily routines are recognised by staff and their right to choose acknowledged. Pictorial routines for each resident are found within the care planning system and these evidence resident choices. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 11 At the current time none of the residents are attending any educational course or work placements, although options are available. Records show that residents are able to go away on holiday and where possible maintain links with family members and spend weekends away. Whilst the staff have a weekly activity sheet in place, drawn up with each resident, this is flexible and is linked to residents’ daily choice. The activity sheet is seen as guidance. The home has a flexible menu system in place, which may change depending upon resident choice. Where possible residents like to eat out at local cafes, pubs etc. Records submitted to the CSCI show that, whilst residents obviously have choice, there could be an opportunity to promote a healthier diet with residents, with regard to a more varied diet and more vegetables. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ healthcare needs are monitored and met. Medication management at the home is satisfactory. EVIDENCE: Records and discussion with staff evidences that residents healthcare needs are met. There is proactive GP input and appropriate referrals. Appointments with specialists are kept and residents’ access services both in and out of the home. Whilst one resident has access to dental services, the other does not as the team have been unable to find a dentist that will visit the resident at home. Extensive records show that when required staff are able to monitor behaviour so that specialists are able to obtain a full picture and adjust treatment accordingly. These records also evidence a positive progression in aspects of residents’ behaviour. The home uses a blister pack system for the administration of medication. This system was checked and found to be in good order with medication Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 13 reviews evident. Whilst there is a returns system in place, this is rarely used and old medications were found in the cupboard that should have been returned in 2005. This should be addressed. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has systems in place, which would help to ensure that residents concerns would be listened to. EVIDENCE: The home has a satisfactory complaints procedure in place, which is available in different formats appropriate to the resident group. The complaints procedure is in the service users guide. There have been no complaints since the last inspection. The home also has pictorial information on local advocacy services for residents. The home has up to date adult protection procedures in place, which includes local guidance from social services. Training records were not submitted to the CSCI, which would evidence staff training on adult protection, prior to or after the inspection. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and homely environment, which meets their needs. EVIDENCE: A partial tour of the home was undertaken. The home was seen to be clean and generally in a good state of decoration. Rooms were seen to be personalised. Since the last inspection the dining area and downstairs toilet have been decorated and this year there are plans to do the stairs. The home has a good lounge with double doors that lead onto a private garden. A fire safety risk assessment has been completed with the local fire officer and systems are in place to check fire safety on a regular basis. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a stable staff team and good recruitment practices, which benefit residents. The staff training programme is wide ranging and covers subject matters which would improve outcomes for residents. EVIDENCE: The home has a stable staff team and no new staff have been recruited in the past two years. Staff files were checked and found to be in good order with all the required checks and documentation in place. Records previously inspected showed that a good staff induction was completed and the manager reports that if new staff are employed then a Skills for Care based induction would be used. Staffing levels at the home are currently meetings the needs of the residents living there. Staff training records submitted to the CSCI show that a wide range of subjects offered to and taken up by care staff, many relating to the specialist needs of residents. Statutory training is also undertaken and includes first aid, food hygiene and manual handling. The team at the home should review Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 17 the manual handling training with regard to current resident need as records show that none of the staff have up to date training on this subject. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the residents benefit from a well run home, where their needs are paramount. EVIDENCE: Both the manager and the deputy manager have worked at the home a long time and both have achieved the NVQ 4 registered managers award. Interaction between the management of the home and the staff team was seen to be relaxed and there was a friendly atmosphere at the home. The organisation operates to ISO 9000, with regard to policies and procedures etc. In addition to this the responsible person visits the home and undertakes Regulation 26 reports. At this time he speaks to residents and Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 19 tries to gauge their feelings about life in the home. As stated before, the home could develop its quality assurance programme by seeking the views of visiting professionals to the home and that have contact with the residents. The home has a health and safety policy in place. Comprehensive risk assessments have been completed on the environment and safe working practices. These are planned to be reviewed every year. Accident records were reviewed and no incidents or accidents have been recorded since 2005. Old records do indicate previous incidents in the past. Safety and maintenance certificates for fixtures and equipment in the home were checked at random and found to be in good order. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 20 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 3 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 21 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. 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. 1. 2. 3. 4. 5. Refer to Standard YA7 YA9 YA17 YA20 YA39 Good Practice Recommendations Person centred care planning should be developed further in the home in order to involve residents more in the care planning process. Risk assessment relating to residents should be kept under review. Efforts should be made with residents to promote healthy options with meals and a more varied diet. Old medications should be return to pharmacy at regular intervals. Quality assurance mechanisms should seek the views of all stakeholders, and inform the annual development of the home. Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Dexter Close (44) DS0000018061.V332613.R01.S.doc Version 5.2 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. 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