Inspection on 18/11/08 for 5 Prince of Wales Road

This inspection was carried out on 18th November 2008.

CSCI found this care home to be providing an Good service.

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 Prince of Wales Road 16/11/06

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 26/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 5 Prince of Wales Road 5 Prince Of Wales Road Dorchester Dorset DT1 1PW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sally Murphy     Date: 1 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 5 Prince of Wales Road 5 Prince Of Wales Road Dorchester Dorset DT1 1PW 01305251935 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dorset Residential Homes Name of registered manager (if applicable) Michelle E Barnes Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: A maximum of 5 service users who have physical disbility may be accommodated at any one time. The registered person may provide the following category of service only: Care home only - Code PC Date of last inspection Brief description of the care home `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 Care Homes for Adults (18-65 years) Page 4 of 29 care home 8 Over 65 0 8 Brief description of the care home 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 individuals support needs. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: .he quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. 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 three service users was looked at in detail during the visit, together with care records, staff records and general home management records. Care Homes for Adults (18-65 years) Page 6 of 29 The registered manager was present during the visit. A tour of the premises was conducted. The AQAA (an annual quality assessment document that all Homes are required to complete) has been used to help form the judgments in the report. The Home was operating within the required conditions of registration set down by The Commission. The conditions of registration set out the type of care and the needs of residents as well as the numbers of residents who may stay at the Home. Comment cards were returned from relatives and health and social care professionals. What the care home does well: What has improved since the last inspection? What they could do better: The home maintains high standards of care and support and provides a valuable short stay service for service users with varying needs. Three recommendations have been made. Care Homes for Adults (18-65 years) Page 8 of 29 The first identifies that information about how to complain, needs to updated, to reflect the closure of the CSCI office in Poole earlier this year and be replaced with the address of the CSCI office in Bristol. Records of the meals eaten by people using the service need to be more detailed and accurate, and it is recommended that the system of recording in use should be reviewed. It is recommended that there are two signatures on all hand transcribed medication. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are introduced to the home in a sensitive manner and staff have comprehensive information that clearly identifies the persons needs and abilities and specifically how the home and or staff will meet their needs. Evidence: Since the last inspection, the home itself, has a more formalised role at the panel stage in the decision about accepting or rejecting referrals. This helps ensure that the home is able to meet the needs of people using this service. A planned introduction to the home is discussed with the person where practical and their carers, and relevant professionals and will usually involve visits to the home prior to an overnight stay. Introductions take as long as required with the aim being to ensure that the home and the person are confident in each others company and the staff feel they understand the persons needs and the most appropriate way to meet them. It is equally Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: important for the person using the service to accept the principle of having a short break and be familiar with all the staff and the environment. Since the last inspection staff from the home have developed their own pre admission assessment documents. These are used in conjunction with the referrers community care assessment. 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 homes diary. 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. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Life style and goal plans and risk assessments describe peoples support needs and how the home and staff work to achieve these. A selection of plans were read on the day of the inspection. They contained detailed information about care needs and were reviewed quarterly or as required. 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. Plans had been reviewed and signed and there was evidence to show that the plans were regularly reviewed and updated. All the files had copies of the Social / Health Service assessments which are the basis Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: 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 the people using the service. The manager said that some people bring a communication passport with them, to aid better communication and would like to encourage the use of these passports with all the people using this service. Some people 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. People 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. There is ongoing work to improve the way that care plans are written and promote a person centred approach. New care plans are to be written in the first person. This approach is meant to help the carer focus on the needs and wishes of the person they are caring for, and be a more dignified way of recording an individuals needs. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A variety of leisure activities and outings are provided to ensure that people using the service have an enjoyable stay. The food served caters for service users choices and preferences and special diets are well catered for. Evidence: Local people accessing Encombe continue to go to their usual day services. There is no activity timetable, but ideas are discussed with residents on a daily basis and arranged according to their individual needs and interests. The home has an Activities sheet, which they encourage parents and carers and /or people using the Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: service to complete prior to their stay. There are plans to have a separate sheet to record activities. The home is close to the town centre and where possible individuals are encouraged to walk into town to access amenities and the shops. Those 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. The manager is currently considering changing to a smaller vehicle, which will be less institutional in appearance, and be suitable for more staff to drive. Menus look to provide a varied diet and a list, discreetly kept on the inside of a kitchen cupboard identified individuals special dietary requirements. At the time of this inspection no consistent records of food consumed were being maintained. This was commented on at the last inspection and although the manager has taken steps to address this, records maintained are still not adequate. Records of the meals eaten by people using the service need to be more detailed and accurate, and it is recommended that the system of recording in use should be reviewed. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service 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 individuals 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 individuals preferences i.e. either being part of the group staying at Encombe or whether they prefer their own company. Arrangements for medication storage and administration are satisfactory. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: 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 resident is admitted for their short stay and the amount taken out of the home when the person is discharged. It is recommended that there are two signatures on all hand transcribed medication Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints and adult protection procedures ensure that service users are protected during their stays. Evidence: 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. It was evident from discussions that staff would be quick to report any incident to senior staff within the organisation. The manager stated that all staff have a good rapport with the parents/carers of people using the service 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 keep me well informed. Information both for staff and for people using the service about how to complain, needs to updated. The address of the CSCI office in Bristol should replace the address of the office in Poole which closed earlier this year. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: There have been no recent complaints or concerns. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of 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 decor 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 resident 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 goodsized dining room, which residents often access for various activities and games. Some bedrooms are equipped with overhead hoists and other specialised equipment to ensure the needs of all the people accessing Encombe can be safely met. A small but accessible and attractive garden has been created (although at this time of Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: the year it was not at its best) and the services of a gardener obtained to maintain it. We were told that it was well used during the good weather . Two new hoists have been fitted to ensure that people using the service are moved safely and comfortably. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A competent and qualified staff group are employed. There are proper recruitment policies in place. Training is well co-ordinated and up to date. 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. There have been few staff changes since the last inspection and the core staff have maintained the home and continued to provide continuity of care to the peoples using the service. There are now more senior staff employed than previously, which reflects the need to have an experienced staff group with a client group that has such diverse needs. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: To promote greater consistency in care, a buddy system for key workers has been developed. Occasional 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. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well organised and provides a safe environment for service users. All staff attend regular mandatory and developmental 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. The records in the home and information taken from the AQQA (annual quality assuarnce assessment) 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 Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: the Care Home Regulations 2001 are carried out. The home uses a feed back sheet, which is circulated to each relative/carer before the residents 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. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 17 Records of the meals eaten by people using the service need to be more detailed and accurate, and it is recommended that the system of recording in use should be reviewed. It is recommended that two staff signatures are obtained for all hand transcribed medication. It is recommended that the complaints procedure be updated to reflect the closure of the Poole office and be replaced with the address of the CSCI office in Bristol. 2 3 20 22 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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