Inspection on 30/10/06 for 5 Dick o` The Banks

This inspection was carried out on 30th October 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

5 Dick o` The Banks 16/02/06

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 Key Announced Inspection 30th October 2006 10:00 Dick o` The Banks (5) DS0000032131.V305412.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 Dick o` The Banks (5) DS0000032131.V305412.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. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 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.V305412.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 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. Current fees are £1296:00 but may vary according to the individual’s support needs. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out as an announced inspection and lasted over four hours. The inspection methods used included observation of documentation, record checks, case tracking and discussions with the manager and one member of staff. There were two residents at home for part of the visit; however, it was not possible to have any discussions with the residents due to their communication difficulties. It was evidenced through the inspection process that staff continue to have a good understanding of individual needs and maintain good relationships with the residents. The home is still in the process of deciding how the reconfiguration of the home/service is to be implemented. What the service does well: What has improved since the last inspection? Since the last inspection the home has successfully recruited additional support staff and this has reduced the reliance on agency / bank staff. The programme of redecoration has been maintained despite the major refurbishment work shortly to commence. The management structure of the home has changed and the home no longer operates with a deputy manager but has elected to appoint three senior support staff to share the responsibilities of the deputy manager’s role and responsibilities. The Manager stated this is working well and appears to be providing a more consistent approach to the overall management of the home. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 6 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. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 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.V305412.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The assessed needs and preferences of individuals are assessed and met. The staff have a good understanding of the residents’ support needs. EVIDENCE: As at previous inspections there have been no changes since the last inspection, in relation to the four people accommodated at the home. Three of the four people have lived together for over fifteen years. The home continues to work closely with specialist services in order to support individuals and offer advice to staff. Records indicated that individuals are referred to specialist consultants when required. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a care planning system in place to provide staff with the information they need to satisfactorily meet the needs of individuals. However, not all the plans viewed had up to date reviews. There are procedures in place to seek the views of the residents but these are mostly based on the staffs’ knowledge and understanding of the residents specific communication abilities as all the residents have limited use of language and are therefore reliant on staff to represent their opinions and views. The home has risk management procedures in place to ensure that individuals are supported safely in taking risks. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 10 EVIDENCE: It was evident through observation and discussion with both the manager and a member of staff that individual (care) plans provide information for staff in order to understand and meet the needs of individuals. This information is based from a series of assessments including ones on communication needs, mobility, daily routines, health checks and risk assessments. The manager stated that the home aims to regularly review all the plans and whilst aspects of the plans had been reviewed it is important that the plans are formally reviewed, signed and dated at least every six months. The manager said that staff act on behalf of individuals based on their experience and knowledge of the residents’ various forms of communication. Both the manager and a member of staff said they would recognise if an individual was unhappy or in distress. Individuals do not routinely participate in household tasks however staff try to encourage, where it is safe to do so, the resident’s presence while they complete the tasks. Risk assessments need to be reviewed in conjunction with the individual plans. Risk assessments included those for bathing, travelling, manual handling, and healthy eating. Also assessed were specific behaviours that may pose a risk to the health and safety of the individual or others living and working in the house. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. 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. Individuals are involved in meaningful and appropriate activities. Links with the community continue to be positive and where possible residents access local facilities and services. The home supports and maintains residents’ links with their family and friends. The home provides residents with a choice of healthy and nutritious meals. EVIDENCE: It was evident through discussions with the manager that individual residents have continued to access opportunities in the community. This included trips to local attractions, eating out and going to the theatre. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 12 Two residents attend an external planned day service and in addition all the residents have one to one time with their key worker. With the staff’s support residents are encouraged to make appropriate and realistic choices. Residents are able to choose if they want to spend time in their bedrooms or in the communal areas. One resident enjoys listening to music in his own room and the manager said the resident is able to indicate a clear choice regarding the type of music they want to listen to. Documentation evidenced that individuals are consulted in areas of their lifestyles. Examples were given of how choices are made such as choosing clothes, and going out for trips. Recent menus were examined and these showed that the home is providing a variety of meals and snacks, which are healthy and nutritious. Residents are given a choice, but staff spoken with confirmed they need to advocate for residents at times. Staff feel this is appropriate as they have good knowledge of each residents’ likes/dislikes. The home has a flexible approach in the planning of meals in order to meet the individual needs of residents. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 13 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. Personal support is offered in such a way to promote and protect individual’s privacy, dignity, independence and preference. The physical and emotional health needs of individuals are well met with evidence of multi-disciplinary working . The practice for the administration of medication to residents is good with clear and comprehensive arrangements being in place to ensure medication needs are met. EVIDENCE: There is no change in that all of the residents are dependent on staff to meet their care needs. Specific and detailed care plans were in place to direct staff in supporting residents with their personal care and mobility. A key worker system operates in the home and the manager believes this practice ensures consistency and continuity of support to individuals. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 14 Individuals are registered with a local GP practice. Records in place evidence that individuals’ physical and mental health needs are monitored on a regular basis. There are no residents who self medicate. Records held for the administration and disposal of medication were well maintained. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to this service. The home/organisation has a satisfactory complaints system with evidence that individuals’ concerns are understood and acted upon by staff. EVIDENCE: No complaints or concerns have been received by the CSCI since the last inspection. As residents are not able to vocalise their views both the staff and families advocate for individuals. The manager explained that residents are able to make themselves understood through physical gestures, body language and vocalisations. The manager said that the home has good relationships with families and was confident that they would be told of any concerns. The organisation has both policies and procedures on the Protection of Vulnerable Adults. There are procedures in place for staff to raise concerns. The majority of staff are completing training in the protection of vulnerable adults as part of their National Vocational Qualifications. However, those staff which includes the manager who are not currently studying for NVQ or LDAF and who completed their training several years ago must ensure they receive refresher training. Please note at the time of the inspection the manager was not able to provide evidence of such training but later advised they had completed a recent training course on the Protection of Adults. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 16 Residents are unable to manage their own finance affairs. It was evident through observation of records and through the discussion with the manager that financial practices are vigorously scrutinised. However some consideration needs to be given to the fact that all the residents’ personal money gets paid into the home’s housekeeping account and then drawn out from this account on their behalf. The manager was unable to specify what the balance of this account was though did explain that all residents have their own bank account which is managed by the organisation for the administration of their individual benefits and allowances and for the payment of their individual fees. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the standard of décor provides homely and comfortable surroundings the organisation is failing to provide a safe and suitable environment to meet the needs of the residents. This is due to the fact that the entire home is going to be demolished and then rebuilt on the same site and in the interim certain aspects of the home do not provide a comfortable and homely environment. EVIDENCE: The manager explained that the organisation is committed to the reconfiguration of the building in providing a suitable environment and is actively working with the Housing Association in agreeing plans and timescales for the full implementation of the works. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 18 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 an effective and competent staff team supporting the needs of the individuals. Staff receive regular training and support to ensure they have the knowledge and understanding to meet the needs of the residents. EVIDENCE: Four staff are currently studying for their National Vocational Qualifications and three staff have already successfully completed their qualifications at both level 2 and 3. The manager stated that since the last inspection the home has experienced some staffing issues in relation to the role and responsibilities of a Deputy Manager and subsequently it has now decided operate the home with the manager supported by three senior support workers. It was evident from discussion with the manager and a staff member that this system seems to be Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 19 working well and that the staff team are now working together and that there is an openness and willingness to try out new ideas. Staffing records evidenced that statutory training was either up to date or planned. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 20 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. The manager ensures the needs and interests of the residents are paramount and this is clearly communicated throughout the service. There are systems in place designed to promote and protect the health and safety of both individuals and staff. EVIDENCE: The manager displayed a good understanding of the diverse range of needs of those living at the home. The management approach is open and positive, with a clear sense of direction and leadership. Staff spoken with said their views are listened to and they feel well supported by the manager. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 21 The manager has informal procedures in place seeking the views of families. Day service reviews, for two residents, form a focus for discussion and are used to seek the views of other service providers and the resident’s family The fire log was up to date with checks on all fire equipment being completed. Records examined evidenced that all staff had attended regular fire training and drills. The arrangements for the reporting and recording of accidents and untoward incidents are satisfactory. Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 22 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 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 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 Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 23 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. 1 Standard YA6 Regulation 15(2) Requirement All Individual Service Plans must be reviewed at least every six months and any changes reflected in the records. The manager stated plans had been reviewed within the last three months however the reviews had not all been dated and it is important to ensure the reviews are dated and signed. The home’s premises are suitable for its stated purpose; accessible, safe and well maintained; meet service users’ individual and collective needs in a comfortable and homely way; and have been designed with reference to relevant guidance. Please note DRH are currently liaising with the Housing Association and are committed to planning and a new building, which will provide a safe suitable and homely environment.. Timescale for action 31/12/06 2 YA24 23 31/08/07 Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 24 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.V305412.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Dick o` The Banks (5) DS0000032131.V305412.R01.S.doc Version 5.2 Page 26 - 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!