Inspection on 16/02/06 for 5 Dick o` The Banks

This inspection was carried out on 16th 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

5 Dick o` The Banks 30/10/06

5 Dick o` The Banks 06/10/05

5 Dick o` The Banks 17/03/05

5 Dick o` The Banks 29/11/04

5 Dick o` The Banks 28/01/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Dick o` The Banks (5) Crossways Dorchester Dorset DT2 7BG Lead Inspector Marion Hurley Unannounced Inspection 16th February 2006 10:00 Dick o` The Banks (5) DS0000032131.V279269.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 Dick o` The Banks (5) DS0000032131.V279269.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. Dick o` The Banks (5) DS0000032131.V279269.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Dick o` The Banks (5) Address Crossways Dorchester Dorset DT2 7BG 01305 267483 01305 267483 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) Dorset Residential Homes Richard James Swift Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Dick o` The Banks (5) DS0000032131.V279269.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th October 2005 Brief Description of the Service: 5 Dick o’ the Banks Road is a care home providing personal care, support and accommodation to four people who have learning disabilities. The home is operated by Dorset Residential Homes, a registered charitable trust that operates a number of care homes in Dorset. The building is a large bungalow, located in Crossways, a village approximately 5 miles from Dorchester. Dick o` The Banks (5) DS0000032131.V279269.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. Dick of the Banks 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 and two staff and two residents very briefly. Both residents had pre-arranged outings. During the inspection records related to the specific standards assessed were checked. The preparation and openess of the Registered Manager assisted the inspection process and the inspector was grateful for their time and commitment to the inspection. What the service does well: Residents are presented with a range of activities that meet their needs and are encouraged to try and participate in new opportunities Residents are supported to achieve their potential and live as fulfilling lives as possible. The home ensures resident keep in touch with their relatives and friends. Thorough record keeping and the positive use of Life Support Plans means that staff understand the needs and wishes of the residents and how they like to be cared for. The manager and staff ensure residents are consulted and involved about every aspect of life in the home and routines are set around the needs of the individual. Good staffing levels enables residents to benefit from one to one time both within the home and outside. Staff have opportunities for regular training and are completing NVQs. Dick o` The Banks (5) DS0000032131.V279269.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. Dick o` The Banks (5) DS0000032131.V279269.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 Dick o` The Banks (5) DS0000032131.V279269.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): N/A None of the above standards were applicable at the time of this inspection visit. This group of four residents have lived together for many years three of whom have been together since youngsters with the other resident joining the group in 2001. EVIDENCE: Dick o` The Banks (5) DS0000032131.V279269.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): The key standards were assessed and met at the previous inspection and were not assessed on this occasion. EVIDENCE: Dick o` The Banks (5) DS0000032131.V279269.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): 13 ,15,16, & 17 • Residents participate in activities, which provide opportunities for personal, practical and emotional development. • Residents are provided with a menu, which is nourishing, varied and meets their individual needs and preferences. EVIDENCE: From examination of Life Support plans and in discussion with the Registered Manager it was clear that residents are provided with a range of activities and opportunities, which stimulate and encourage the acquisition of life skills. Residents are involved with the shopping, cooking, cleaning and laundry activities in the home and these are documented in their Life Support plans. For some residents’ participation in the activities involves observing and being present while another completes the tasks for example one resident’s goal is “to assist my carer in household tasks”. Two residents attend day services and this provides opportunities for them to meet with their peers and enjoy community experiences in a different locality. The others who do not go to Day services have similar community experiences locally with the staff from the home. Outings to garden centres, café, and Dick o` The Banks (5) DS0000032131.V279269.R01.S.doc Version 5.1 Page 11 pubs have all been achieved. Where practical the local shops are used and a couple of the residents really enjoy walking in the local vicinity where they are often stopped and spoken with by other local people. A record of all participation is recorded in the resident’s Life Plan, staff initial and date the accomplishment and any specific comments are added. Residents are encouraged to maintain contact with their relatives and the Registered Manager described the different contacts, which vary from weekly overnight stays to monthly visits. Staff are always willing to support the relatives in the home situation if this helps to provide reassurance to both the resident and the relatives. Families are invited to contribute to the residents Life Plans and can be involved in any medical reviews and consultations. The home provides an exceptionally nourishing and interesting menu, which meets the needs of the resident based on their preferences, likes and dislikes. Residents are provided with choice and variety and are regularly consulted about the menu. Records of food consumed are recorded and any comments added. Food shopping is delegated in turns to the staff who also all share the cooking. All the residents enjoy their meals. Each resident has a meal plan which describes how to support the resident to maintain a healthy diet, how they like food prepared and presented, how they eat their food for example two residents have difficulty in swallowing and therefore require some foods to be pureed, a record of any special crockery and cutlery is noted and whether the resident is happy to eat in company or prefers to eat alone. Three of the residents eat as a family group with the fourth much happier to eat independently though they are continually observed from a distance. The Environmental Health Officer inspected on 13:01:06 and issued a number of requirements and these have all been met and signed off by the Officer at the follow up inspection on 14:02:06. Dick o` The Banks (5) DS0000032131.V279269.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 and found to be in order. The system adopted for the administration of medication is the monitored dosage system. This system reduces the likelihood of medication error and provides an accurate record of administration. All staff receive in house training and only commence responsibility for the administration of medication once the Registered Manager has signed and recorded their competency in completing the duties. DRH has comprehensive policies and procedures for the management of residents’ medication and it was clear from the records and storage that the procedures were being carefully followed and implemented at the home. Each resident has a medication profile which the GP, Consultant, Registered Manager and next of kin sign. The profiles read were very well written providing details of how and why the resident requires their prescribed medication, possible known side effects, drug identification and specific instructions on how the medication needs to be administered i.e. for one resident medication needs to be administered with yogurt and should be visible not hidden. The home stores supplies of medication for one month only. Dick o` The Banks (5) DS0000032131.V279269.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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: DRH has comprehensive policies and procedures for dealing with any complaints or allegations of abuse. All staff must sign to indicate they have read the policies and procedures. All staff have been issued with details of the local multi-agency publication No Secrets. The Registered Manager is confident all staff would be very clear on how to implement the correct strategies for dealing with situations, which may include allegations of abuse. The home has not received any complaints since the last inspection. The Registered Manager said that staff were clear about what to do to ensure that residents are kept safe and are very careful to ensure that all residents are actively listened to and that any concerns would be identified. Residents express themselves in variety of non-verbal ways however staff are experienced and knowledgeable at interrupting the messages of the residents and any change in the resident’s behaviour would be carefully monitored and responded to. The Registered Manager said that the residents are constantly observed and all incidents are recorded to ascertain any causes or issues, which might be acting as a trigger to the resident. Residents’ welfare is always raised and discussed at staff meetings and close liaison with families and other service providers ensure all aspects of the residents’ welfare are considered. Dick o` The Banks (5) DS0000032131.V279269.R01.S.doc Version 5.1 Page 14 Established ways to protect residents at such times when they may attempt to self-harm are agreed with all the staff. This group of residents are very vulnerable due to their restricted methods of communicating their needs and feelings and for this reason the Registered Manager stated that staff are always vigilant and regularly check for any physical marks at each bath time. This information was further verified from reading daily notes and the support plans of two residents. Dick o` The Banks (5) DS0000032131.V279269.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): N/A The key standards were assessed and met at the last inspection and were not assessed at this inspection visit. EVIDENCE: Although these standards were not assessed the inspector took the opportunity to view the resident’s bedrooms and each is very individually decorated and reflect the resident’s interests. Several rooms have photographs of family and friends. One resident enjoys watching television and they have their own television and video. Along the walls are sensory and tactile displays and one person who has tunnel vision has extra sensory equipment installed in their bedroom. All the residents have chosen their own bedding and towels which helps them identity it when there are doing their own laundry. This home is scheduled for major refurbishment and this includes all the resident’s bedrooms. The home was clean, hygienic and free from any residual odours. Dick o` The Banks (5) DS0000032131.V279269.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): 32 ,34, & 35. • A well trained and committed staff group are meeting the needs of each individual resident in a sensitive and professional manner. • Recruitment policies and procedures are comprehensive and implemented ensuring the safety of the residents. • The Registered Manager ensures there are adequate numbers of staff on duty in order to meet the needs of the residents. EVIDENCE: Staffing numbers are maintained with the 24 hours divided into two main shifts from 07:00 –14:30; and 14:00 – 21:30. Night staff commence their duties at 21:15 and work until 07:15. A senior support worker is designated to lead each shift and generally works with one other support worker. Rotas are worked out a month in advance and include supervision sessions, annual appraisals and the monthly staff meetings. When the Registered manager is on leave the responsibility for administering medication is also identified on the rota. The home currently has two vacancies and the Registered Manager reported the excellent response from the staff team to over the extra shifts until the vacancies are filled. Six of the staff have worked together for over six years and the Registered Manager commented how well they work as a team and support each other. Dick o` The Banks (5) DS0000032131.V279269.R01.S.doc Version 5.1 Page 17 All staff have completed training logs and an example of these were read on the day of the inspection visit. The Registered Manager sets aside two days per year for the completion of mandatory training. This forward planning ensures all staff are up to date in this training. Specialist training linked to the needs of the residents is organised through DRH and some staff have completed training on dysphasia, epilepsy and understanding challenging behaviours. One senior support worker has achieved their NVQ level 3 and is now working toward the assessor’s award and the other senior is currently completing NVQ 3. Five staff have already achieved NVQ levels 2 and 3 and one is due to start level 3 and another is just completing their qualification. This is an excellent commitment to NVQ training. Dick o` The Banks (5) DS0000032131.V279269.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 39 • Residents benefit and are supported by a team of staff that are aware of their roles and responsibilities and our led by a competent and wellorganized Manager. EVIDENCE: The manager and staff have many years experience of working with residents who have complex needs. The home is well run and organised and the policies and procedures put in place by DRH safeguard both the residents and staff and help protect the residents and their unique needs. Residents’ benefit from a high standard of care, which is a credit to the general knowledge, and skill of the staff team and their success in working together . Quality assurance and monitoring systems are ongoing. Regular staff meetings and supervision help monitor the quality of care provided and ensure staff maintain their competencies. The “responsible individual”/ representative for Dorset Residential Homes completes the monthly monitoring visits. Regulation 26 reports are comprehensive and extremely useful and provide a good picture of life in the home. Dick o` The Banks (5) DS0000032131.V279269.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 N/A 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 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 x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 3 x 3 x 3 x x x x Dick o` The Banks (5) DS0000032131.V279269.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Dick o` The Banks (5) DS0000032131.V279269.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Dick o` The Banks (5) DS0000032131.V279269.R01.S.doc Version 5.1 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!