Inspection on 16/11/06 for 5 Prince of Wales Road

This inspection was carried out on 16th November 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

5 Prince of Wales Road 18/11/08

5 Prince of Wales Road 07/02/06

5 Prince of Wales Road 27/10/05

5 Prince of Wales Road 15/02/05

5 Prince of Wales Road 18/06/04

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 Prince of Wales Road (5) 5 Prince Of Wales Road Dorchester Dorset DT1 1PW Lead Inspector Marion Hurley Key Announced Inspection 16th November 2006 10:10 DS0000059023.V305554.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 DS0000059023.V305554.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. DS0000059023.V305554.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Prince of Wales Road (5) Address 5 Prince Of Wales Road Dorchester Dorset DT1 1PW 01305 251935 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 Michelle E Barnes Care Home 8 Category(ies) of Learning disability (8) registration, with number of places DS0000059023.V305554.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 4 service users who have physical disabilities may be accommodated at any one time. 7th February 2006 Date of last inspection Brief Description of the Service: ‘Encombe’ is situated in Prince of Wales Road, close to the town centre of Dorchester and provides a ‘short stay’ residential care facility for learning disabled adults who otherwise will generally be living in their family home. Around thirty adults use the service and the home is able to accommodate up to eight service users at any one time, with facilities for up to 4 service users who have additional significant physical disability. The length of stay at ‘Encombe’ can be from a few hours to a number of weeks and is arranged to meet the needs of service users and their supporters; most stays are arranged in advance, but the home will respond to a crisis situation where possible. The home provides staff throughout the 24-hour day, including awake and sleep-in staff. A copy of the last inspection report is available directly from Encombe or from Dorset Residential Homes head office in Dorchester. Current fees are £987:00 per week but may vary according to the individual’s support needs. DS0000059023.V305554.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history and through visiting the home. The visit took place over approximately four hours. The support received and the experience of two service users was looked at in detail during the visit, together with care records, staff records and general home management records. The registered manager and deputy were present during the visit. A tour of the premises was conducted. The manager completed a pre-inspection questionnaire, and 8 comment cards were returned from relatives and health and social care professionals. What the service does well: The home is well organised and parents like the way the service is run. Parents and carers are reassured that their relatives are receiving good care and support and enjoy their short stays. The home is well equipped to meet both the complex emotional and physical needs of service users. Staff communicate with service users and respect their choices and decisions. Service users are encouraged to use their skills in helping around the home. Staff encourage independence, whilst making sure that service users are not put at risk. There is a range of activities for service users to enjoy both within the home and through accessing local amenities and facilities. The home is comfortable and well maintained. DS0000059023.V305554.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. DS0000059023.V305554.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 DS0000059023.V305554.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 good. This judgement has been made using available evidence including a visit to this service. Service users are introduced to the home in a sensitive manner, and staff have comprehensive information that clearly identifies the service users needs and abilities and specifically how the home/staff will meet the service user’s needs. EVIDENCE: All referrals for short breaks are made through Health and Social Care Services. Referrals are presented to a multi-agency panel and if members of this panel accept the referral in principle the community care assessments are passed to the manager for further consideration. A planned introduction to the home is discussed with the service user (where practical) and their carers, and relevant professionals and will usually involve visits to the home prior to an overnight stay. The home is currently considering four new service users and the manager explained that for one person the introductions may take up to twelve months until the home and the service user are confident in each others company and the staff feel they understand the service user’s needs and the most appropriate way to meet them. It is equally important for the service user to DS0000059023.V305554.R01.S.doc Version 5.2 Page 9 accept the principle of having a short break and be familiar with all the staff and the environment. Staff from the home do not use their own pre admission assessment documents but choose to utilise the referrer’s community care assessment, which is adopted as the basis of the service user’s Life Style and Goal Plans. The manager may wish to consider utilising the organisations own documentation for this purpose. The home arranges the bookings for short stays efficiently and dates are agreed with families and services users six months in advance to assist with the planning. Bookings are electronically updated on a spreadsheet and manually in the home’s diary. DS0000059023.V305554.R01.S.doc Version 5.2 Page 10 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. Life style and goal plans and risk assessments describe service users’ support needs and how the home and staff work to achieve these with the service users. A selection of plans were read on the day of the inspection and whilst they contained a considerable amount of information there was not sufficient evidence to indicate they had been regularly reviewed. All Plans and risk assessments should be reviewed at least every six months and updated to reflect changing needs. DS0000059023.V305554.R01.S.doc Version 5.2 Page 11 EVIDENCE: Life Style Plans contain a wide range of information about the service users and their daily support needs. The goal plans identified specific needs i.e. continence, behaviour and choices and documented likes and dislikes and preferred routines. However, those read on the day had not been signed or dated so it is not clear who wrote them, or when they were written. A few specific sections of the plans had been reviewed and signed. However there was no evidence that the plans were regularly reviewed and updated. All the files had copies of the Social / Health Service assessments which are the basis of the Life Style Plans. Daily records described day-to-day activities. Different methods of communication were recorded and the manager stated that staff have a good understanding of the communication needs of service users. One record described how a service user might lift an eyebrow to indicate yes, other service users may display more exaggerated non-verbal gestures to indicate their needs. Some service users are able to express themselves verbally. However; the majority of those accessing the service rely on non-verbal communication and or a variety of different sounds. Service users are encouraged to be as independent as possible, whilst staying at Encombe. They can prepare snacks, and help with meals. All have risk assessments regarding health and safety DS0000059023.V305554.R01.S.doc Version 5.2 Page 12 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. A variety of leisure activities and outings are provided to ensure that service users have an enjoyable stay. The food served caters for service users choices and preferences and special diets are well catered for. EVIDENCE: Local service users accessing Encombe continue to go to their usual day services. There is no activity timetable, but ideas are discussed with service users on a daily basis and arranged according to their individual needs and interests. The home has introduced a new Activities sheet, which they hope parents and carers and/or service users will complete prior to their stay. DS0000059023.V305554.R01.S.doc Version 5.2 Page 13 The home is close to the town centre and where possible service users are encouraged to walk into town to access amenities and the shops. Service users who do not attend regular day services are provided with flexible routines, to suit their needs and preferences The home has a mini bus, which is accessible for people who use wheel chairs. However, at the present time only a limited number of staff drive the vehicle, which therefore restricts the use. Menus looked to provide a varied diet and a list, discreetly kept on the inside of a kitchen cupboard identified service user’s special dietary requirements. At the time of this inspection no consistent records of food consumed were being maintained, but the manager has already taken action to address this and showed the inspector the new book where records will be kept. DS0000059023.V305554.R01.S.doc Version 5.2 Page 14 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. Service users receive good support, and their health care needs are well catered for. There are safe procedures for the administration of medication. EVIDENCE: The home is equipped to care for people with mobility difficulties, with hoists, hi-lo bath and grab rails. In addition service users may bring with them any special items of equipment they need during their stay. The lifestyle plans contain information and records in relation to indivual health needs e.g. epilepsy. There are clear entries for specific health interventions and any changes to needs or support requirements. Emotional needs are also described and included reference to service users’ preferences i.e. either being part of the group staying at Encombe or whether they prefer their own company. DS0000059023.V305554.R01.S.doc Version 5.2 Page 15 Arrangements for medication storage and administration are satisfactory. Parents/carers are asked to complete a medication information sheet, giving details of current medication, before a visit. The home has a fridge for storing medications that need to be kept below room temperature, and temperatures of this fridge had been regularly recorded. There are clear medication sheets which detail the medication and quantities received when a service user is admitted for their short stay and the amount taken out of the home when the service user is discharged. DS0000059023.V305554.R01.S.doc Version 5.2 Page 16 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 complaints and adult protection procedures ensure that service users are protected during their stays. EVIDENCE: There have been no recent complaints or concerns. Dorset Residential Homes has comprehensive policies and procedures concerning complaints and concerns and the Protection of Vulnerable Adults and these are regularly reviewed and updated when necessary. It is important all staff have an understanding and knowledge of the adult protection procedures. Whilst it was evident from discussions that staff would be quick to report any incident to senior staff within the organisation it is equally important they can display a working knowledge of the procedures and the need to work within the multi disciplinary guidelines of the publication “No Secrets”. The manager stated that all staff have a good rapport with the parents/carers of service users and is confident that any staff or parent/carer would raise any issues or concerns directly with the home and staff. One comment card stated “the staff at Encombe work with me”. DS0000059023.V305554.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 good. This judgement has been made using available evidence including a visit to this service. Service users benefit from comfortable bedrooms, within a well maintained, clean and tidy home. EVIDENCE: During a tour of the home the environment was found to be clean, tidy and hygienic throughout; with the furniture and décor well maintained. Substances used for cleaning were securely stored and the home benefits from separate sluicing facilities. The large lounge can be divided into two which ensures any service user who does not want to be in the same room as the television can choose to spend time in the quiet end. A range of sensory equipment is available in this part of lounge. There is a good-sized dining room, which service users often access for various activities and games. DS0000059023.V305554.R01.S.doc Version 5.2 Page 18 The rear garden is small but accessible and the additional garden furniture has encouraged service users to access it more frequently. Some bedrooms are equipped with overhead hoists and other specialised equipment to ensure the needs of all the service users accessing Encombe can be safely met. DS0000059023.V305554.R01.S.doc Version 5.2 Page 19 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. A minority of the staff have worked together since the home was opened however since the last inspection 6 staff have left for various and valid reasons. The home is now in the process of a recruitment drive to replace these staffing hours. Training is well co-ordinated, but some staff are overdue fire training. EVIDENCE: Two staff files were looked at and recruitment records required by the Care Homes Regulations 2001 were in place including Criminal Record Bureau checks and employment references. All new staff receive comprehensive introduction and complete the LDAF training, which leads to National Vocational Qualifications. DS0000059023.V305554.R01.S.doc Version 5.2 Page 20 There has been a considerable amount of staff changes since the last inspection however the core staff have maintained the home and continued to provide continuity of care to the service users. Regular agency and or bank staff have been used to supplement the staff hours to ensure adequate staff cover has always been available to maintain the service. In theory there are two staff per shift, though this can be increased according to the number of people staying at the time. Staffing is often increased at weekends to ensure service users can access different activities. Each member of staff has an individual training record, which clearly shows the date they received training and when the next mandatory training is due. Training opportunities are good within the organisation and staff are encouraged to pursue their National Vocational Qualifications. DS0000059023.V305554.R01.S.doc Version 5.2 Page 21 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 adequate. This judgement has been made using available evidence including a visit to this service. The home is well organised and provides a safe environment for service users. All staff must attend regular fire training. EVIDENCE: The manager has appropriately delegated responsibilities to senior staff i.e. fire equipment tests, training for manual handling, infection control and risk assessments. However, the manager continues to have overall responsibility for all health and safety aspects and undertakes random audits to ensure all delegated tasks are up to date. DS0000059023.V305554.R01.S.doc Version 5.2 Page 22 The records in the home and information taken from the pre-inspection questionnaire provided evidence of regular health and safety and maintenance tests, ensuring a safe environment for service users. There was evidence that regular monthly management visits under Regulation 26 of the Care Home Regulations 2001 are carried out. The home uses a feed back sheet, which is circulated to each relative/carer before the service users next short stay. However, the manager said not many are completed. The organisation is aware of the need to formalise a quality assurance monitoring system and this is being addressed. DS0000059023.V305554.R01.S.doc Version 5.2 Page 23 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 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 2 x DS0000059023.V305554.R01.S.doc Version 5.2 Page 24 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 Timescale for action 31/01/07 2 YA23 13(6) 3 YA42 23(4)(d) Service user’s plans must be kept under review and reviewed at least every six months and updated to reflect changing needs. Please note a new review system is currently being developed. All staff must have a working 31/01/07 knowledge of the Organisations policies and procedures for the Protection of Vulnerable Adults. Please note at the time of this inspection a training programme has been arranged to ensure all staff are updated on the Protection of Vulnerable Adults. All staff must undertake 31/12/06 regular fire training 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 DS0000059023.V305554.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 DS0000059023.V305554.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. 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