Inspection on 20/02/06 for 44 Dexter Close

This inspection was carried out on 20th February 2006.

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 13/03/07

44 Dexter Close 11/07/05

44 Dexter Close 22/11/04

44 Dexter Close 06/04/04

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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 Vicky Dutton Unannounced Inspection 20th February 2006 10:30 Dexter Close (44) DS0000018061.V281122.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 Dexter Close (44) DS0000018061.V281122.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. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 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.V281122.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 2005 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. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of two and a half hours, and considered a number of the National Minimum Standards. The registered manager was present throughout most of the inspection. A tour of the premises took place and care and staff records were inspected. Two residents were being accommodated and at home during the inspection. One resident was spoken with. The other resident has more complex communication needs. Time was spent with both residents. No visitors or visiting professionals were present during the inspection visit. 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. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 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.V281122.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: No standards under this section were assessed at this inspection. No new admissions to the home have taken place since previously assessed and satisfactory. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Residents care plans reflect their needs and show that they are encouraged to make choices and decisions in their daily lives. EVIDENCE: The care plan of the most recently admitted resident was viewed. This resident has complex needs and is largely unable to verbalise their wishes. The care plan was detailed and gave specific instructions to staff as to how to meet the resident’s needs and maintain their preferred routines. The home operates a key worker system. This was reported to be working particularly well with one resident. Care plans are kept under review, but neither resident at the home has had a recent formal review of their care by the funding authority. During the visit staff were noted to encourage residents to make personal choices and decisions. Residents are assisted appropriately in accordance with their needs in managing their personal finances. One resident has no independent person/advocate to offer them support. Although this particular residents current reactions to strangers/changes in routine may make this difficult, the situation should be kept under review. Appropriate risk assessments were in place. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 9 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. Residents are encouraged to undertake activities that will aid their personal development. Family contact is encouraged and maintained. Resident’s are able to choose what and when they wish to eat. EVIDENCE: Neither resident at Dexter Close attends any formal day care placements. This is through choice in one case, and complex needs and unwillingness to leave the building in another. One resident enjoyed telling the inspector about a voluntary job doing gardening that they hoped to soon start. From discussions with staff it was clear that residents are offered options to undertake developmental courses and other activities. One resident is able to independently access the local community and makes full use of local shops and amenities. One resident will not currently leave the premises. The other service user enjoys their personal choice of activities. Day outings or longer trips are arranged on an individual basis or, in conjunction with the residents of the jointly managed sister home to Dexter Close. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 10 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): 18, 19, 20. Resident’s healthcare needs are assessed and met. Medication at the home is managed safely to protect residents. EVIDENCE: Residents at Dexter Close follow their own preferred daily routines in such areas as bathing, rising and retiring. Both are physically independent and do not require any specialist aids. Care files and discussion with staff showed that residents have their healthcare needs met. Professional input from, for example, behaviour therapists and speech therapists is sought when required, and their advice acted upon. One resident will not currently leave the premises, and has complex behavioural needs. As at the previous inspection, in spite of since exploring different avenues, the home has been unable to access a suitable domiciliary dentist. The medication records and system, (monitored dosage), were viewed and no anomalies were noted. The registered manager confirmed that all staff have undertaken medication training. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 11 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 home has a complaints process in place, and residents are encouraged to express any concerns. Staff are aware of adult protection issues. EVIDENCE: No complaints have been received by the home or CSCI. A resident spoken with said that they knew how to raise any concerns with the staff or management of the home and was sure that things would be dealt with properly. Training records viewed showed that staff have undertaken training in adult protection. In particular the registered manager and deputy manager have both recently undertaken training and are specialist practitioners for adult protection in the area. Since the previous inspection staff have undertaken training in managing challenging behaviour. The home have also been working closely with a behaviour therapist. During the inspection an incident of challenging behaviour was dealt with calmly and competently by a member of staff. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 12 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): 24 - 30 Residents live in a safe and homely environment that meets their needs. Both have their own rooms and sufficient shared communal space. EVIDENCE: A tour of the premises was undertaken. The registered manager confirmed that there have been no changes to the building since the previous inspection. Dexter Close provides a comfortable and homely environment in a community setting close to local amenities. Sufficient space is provided. There is an open plan kitchen/dining area, and a comfortable lounge. The home was well decorated and maintained. Furnishing and fittings are domestic in character. A sleeping in room is provided for staff. Both residents have their own rooms, which reflect their personal interests. A resident spoken with was happy with his room. It was noted that the armchair in this room was in poor condition and broken. It was reported that this was the resident’s own property, and that the residents family wished it to remain in the room. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 13 Dexter close has one bathroom and a downstairs cloakroom. The home has a small garden, which is enjoyed by residents. Normally this area is enclosed and secure but currently the back gate is missing and awaiting repair/replacement by the local council. This poses a potential hazard to one resident at the home and has been chased up by staff at the home. Neither resident currently requires any specialist aids. The homes laundry area is situated in the homes garage, which has been organised to serve as a utility area. Due to the layout of the home this area is accessed through the kitchen. There are no hand washing facilities in the utility area. The registered manager was advised to provide hand cleaning gel to facilitate adequate infection control. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 14 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, 35 Staff at the home receive a good level of induction and training to assist them in caring for residents well and safely. EVIDENCE: No new staff have been recruited by the home since the previous inspection. Records previously viewed showed that staff are given a good induction by the home. One member of staff recruited just prior to the previous inspection said that they had just completed their NVQ level two award. Staff training records viewed showed that staff had undertaken appropriate core and other training. A profile of each staff members training is kept. The registered manager said that training needs are discussed as part of supervision. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 15 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, 38, 39, 42 Resident’s benefit from a well run home that is focused on their needs and views. EVIDENCE: The registered manager and deputy manager are both experienced and hold NVQ level four/Registered managers awards. Dexter Close is a small home providing care to a maximum of two service users. The registered manager, staff, residents and one residents family all appear to communicate and interact closely in an open and friendly environment. Although one resident has complex needs, staff constantly encourage them to express their views by signs or other means. SESNHA have elements in place that contribute to quality assurance. Monthly visits are undertaken by the registered provider, as required under regulation 26 of the care homes regulations. The organisation operates to ISO (International Standards Organisation) standards and are regularly audited under this scheme, which relates primarily to policies and procedures. However Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 16 they have yet to actively seek the views of all stakeholders of the service and use this information to inform an annual development plan for the service. The home is run in a safe and effective manner. All staff have received training in moving and handling and other essential core areas such as food hygiene. Equipment and safety information viewed showed that appropriate servicing and maintenance take place to safeguard residents and staff. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 17 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 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 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 3 Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 18 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. Refer to Standard YA19 YA9 YA39 Good Practice Recommendations Advice should be sought from the local Health Authority as to how to meet the dental needs of one resident. The need to appoint an independent advocate for one resident must be kept under review. Quality assurance mechanisms should seek the views of all stakeholders, and inform the annual development of the home. Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Dexter Close (44) DS0000018061.V281122.R01.S.doc Version 5.1 Page 20 - 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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