Inspection on 02/06/05 for 56 Monks Dyke Road

This inspection was carried out on 2nd June 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

56 Monks Dyke Road 20/09/06

56 Monks Dyke Road 23/02/06

56 Monks Dyke Road 13/01/05

56 Monks Dyke Road 07/04/04

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Applegarth

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Beech Lodge

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Hunter`s Lodge

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

CARE HOME ADULTS 18-65 56 Monks Dyke Road 56 Monks Dyke Road Louth Lincolnshire LN11 0NY Lead Inspector Vanessa Gent Unannounced 2 June 2005 @ 10.00 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 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 Stationary 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. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 56 Monks Dyke Road Address Louth Lincolnshire LN11 0NY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01507 610877 01507 610877 fiona.kennedy@sense.org.uk Sense East Fiona Kennedy Care Home -CRH 7 Category(ies) of Sensory Impairment (7) registration, with number Learning Disability (7) of places 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered to admit a maximum of 7 service users in the categories Learning Disability (LD) or Sensory Impairment (SI). Date of last inspection 13/01/05 Brief Description of the Service: 56 Monks Dyke Road is one of a number of care homes within the county operated by SENSE East and is located in a residential area in the market town of Louth. The building is owned by a housing association which has maintenance responsibilities. It was originally a family home. It provides personal care and support in single rooms for up to seven service users over the age of eighteen. Three bedrooms have ensuite facilities. The home has a safe, enclosed garden at the rear of the property and car parking spaces at the front and rear of the house. Transport is provided through the use of a minibus and staff cars. The stated aim of the home is to provide a safe and supportive environment for the people it cares for. The objectives are to provide a warm and homely place, to respect each individuals privacy and dignity, to support service users and their families to be as independent as possible, to provide staff with training and to check on how well the service is doing through monitoring and reviewing it regularly. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over about six hours. The inspector was able to meet with all the service users and speak with all the staff on duty during the inspection. The main method of inspection used is called case-tracking, which involves selecting a proportion of residents, and tracking the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. The term ‘guys’ is the preferred term used in the home for the service users. What the service does well: What has improved since the last inspection? What they could do better: Some care plans would benefit from more detail to show how the service users’ needs are to be met; they need to be reviewed monthly and should show that the service user or relative has been involved in the care plans. The room in which medicines are stored must be maintained at a temperature appropriate to requirements. (Administration and Control of Medicines for Care Homes and Children’s Services: RPSGB) 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 6 Getting out of the back of the home in a wheelchair is difficult and slow, as demonstrated during a fire drill. Ramps are needed to get out the building from the rear exits safely and easily. A new washing machine with sluicing facilities has yet to be installed although evidence that this is in hand and will be done within the next couple of months was provided. 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. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 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 standard(s) 2, 3, 4 The home has thorough procedures in place to ensure that people placed at the home will be given appropriate care and their needs will be met. EVIDENCE: In care plans examined, assessments prior to moving into the home have been carried out and clearly describe the needs of the service users and how to meet them. The relatives of a recently admitted service user say they have been involved in the whole process of assessment, visits to and stays at the home and settling the service user in without causing undue discomfort or anxiety. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8, 9 Care plans show a person-centred approach to care and support, which enables them to develop their independence, have choice and take risks within their capabilities, in a safe and supported manner. EVIDENCE: Minor improvements to some care plans are needed, such as the assessments and care plan issues being more clearly identified. Reviews of care plans have been carried out regularly. Relatives spoken with say they have been involved in the creation of the care plans and that the service user’s wishes, likes and dislikes have been recorded and, they have been assured, will form the basis of the care given to him. Their signatures were seen to confirm their involvement in and knowledge of the care plans although involvement of service user or representative was not evidenced in other care plans examined. Care plans examined are well-composed, precise, clear and give a holistic picture of each service user’s life in the home. They are reviewed regularly. The care plans show that service users are supported to live as independently as they are able, have choice and autonomy and may take risks within their capabilities. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 10 Service users’ meeting are held regularly and minutes taken that show participation of the service users where this is possible. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 17 A wide range of activities is available to suit the service users accommodated at the home which accord with their wishes and assist them to have fulfilment in their lives. The food provided is in accordance with the service users’ choices and can provide a balanced diet. EVIDENCE: Evidence of plenty of activities being provided and taken part in was seen in the good recording in care plans and activity sheets and in talking with service users on their return home from their various activities. These allow the service users the opportunity to develop within their capabilities. Most service users attend a Resource Centre up to five days every week. All are taken to communal activities in the transport provided or in staff cars. Local leisure facilities are used to provide exercise, engagement and fun. Service users say that food is provided in sufficient quantity and choice. Fresh fruit and vegetables were seen in stock and in use for the home-cooked evening meal, which looked appetising and nutritious. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 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 standard(s) 18, 19, 20 The health of service users is maintained by close liaison with healthcare professionals. Service users are happy with the care and attention they receive at the home. Medication practices are mostly thorough and robust. EVIDENCE: Encouragement is given by staff as necessary to maintain service users’ personal hygiene. One service user was seen being supported in her personal house chores. Some staff can ‘sign’ and others are being trained to communicate with deaf/blind people to ensure that staff understand what service users want, need and choose. Service users made sure the inspector understood that they are happy living at the home and feel supported by staff with whom they have a good rapport. Healthcare professionals are contacted and specialist equipment provided as necessary to ensure that the service users’ physical health needs are met. No service user wishes or is able to administer their own medicines. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 13 The daily temperatures of the room used to store medicines are not recorded as required by The Royal Pharmaceutical Society of Great Britain, in “The Administration and Control of Medicines in Care Homes and Children’s Services”, June 2003, Section 5.1, paragraph 2. Training has been undertaken by all staff who administer drugs. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 22, 23 Service users benefit from robust complaints and adult protection procedures and the staff’s awareness of the policies and procedures in place to keep service users safe. The home ensures that the service users have the opportunity to voice their views and opinions. EVIDENCE: There is a complaints policy notice displayed publicly. No complaints have been received either by the home or directly to the Commission for Social Care Inspection during the past twelve months and no allegations of adult abuse have been made at the home. The inspector saw that service users interact freely with staff and feel safe. Service users look well-cared for and are happy and relaxed. Service users are able to air their views at the regular meetings held, the minutes of which were seen at the inspection. Staff have received training in how to protect vulnerable adults and were able to demonstrate an understanding of Adult Protection procedures and a knowledge of the Whistle Blowing policy. Update training in Adult Abuse Awareness is booked to take place in July 2005. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 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 standard(s) 24, 25, 26, 27, 28, 29, 30 Service users are provided with a clean, comfortable and homely environment which is adapted to meet their needs and accommodate their choice. Emergency evacuation from the building is not safe for all service users including wheelchair users. EVIDENCE: The home is clean and tidy throughout. The rooms are modern and bright, with every room being decorated to a high standard and to suit the service users’ tastes and needs. The kitchen, which is open-plan and in the style of a family home kitchen, is kept clean and tidy. All bedrooms are highly personalised and fitted with specialist equipment and sensory appliances where necessary to promote independence and respect individual choice. All communal areas are spacious and comfortably fitted. One room is a sensory area with lights and soft furnishings for specialist care. There are sufficient bathrooms, shower rooms and toilets on each floor to meet the service users’ needs and respect their privacy and dignity. The home is awaiting the delivery of an industrial style washing machine with a sluice programme, as required at the previous inspection. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 16 A fire drill took place during the inspection which highlighted the need for ramps to be fitted to the rear doors leading from the conservatory for the safe evacuation of service users in wheelchairs. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36 The service users are protected by safe staffing numbers, skill mix and procedures which include pre-employment checks, training and supervisions. EVIDENCE: The home’s duty rota and statement of purpose confirms that the staffing of the home reflects service users’ needs: currently there is a ratio of five staff members to seven service users during the day. At night there is always one wakeful staff member and one who is “sleeping-in” and on-call. Checks for the protection of service users, including CRBs (Criminal Records Bureau) and Protection of Vulnerable Adults (POVA) checks have been made for each staff employed and are in place in staff files examined. Staff say they have gone through a robust induction and training programme and understand their roles and responsibilities. Staff say there is plenty of training available, encouraged and undertaken and that they are encouraged to take NVQ (National Vocational Qualifications) courses up to level 4. Staff say that the rapport and communication between them is “very good”; they are part of a close and supportive team. Staff say they “feel listened to and their opinions are valued and things put into place”. Regular staff meetings are held. Staff say they are kept informed of all progress and changes that take place in the home and with the service users. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 18 Each staff spoken with is supervised monthly and feels very supported. Staff say that the manager recognises capabilities in staff and supports them through promotion and respect. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 41, 42 The home is well-run, with the manager providing good leadership and support. Most measures in place in the home safeguard the health, safety and welfare of the service users and staff. EVIDENCE: The manager is undertaking the Registered Managers Award. She has had twelve years experience in residential and day care services, is a moving and handling and mobility trainer and is a fluent ‘signer’ (sign language). Staff feel supported, encouraged and listened to by the manager. “If there are any issues, all of us can speak up.” The manager says that the managers of the Charity, Sense, are supportive and helpful, so she feels confident and competent in her work. Regular monitoring of the service provided is carried out by the regional manager and the home’s manager to ensure that the health, safety and welfare of the service users is promoted. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 20 Service users show, staff all say and the inspector found, that the atmosphere of the home is very positive, happy and encouraging, and that there is a good rapport between service users, staff and manager. Service users feel they have lots of choice in their lives and contribute to the home’s development. The staff training programme is robust and protects the service users. Recordkeeping is excellent: clear, precise and easy to follow. A new maintenance man has been employed and maintenance records are in good order, with all health and safety checks made regularly and welldocumented. Fire awareness training, fire alarm testing, fire drills and servicing of equipment are done regularly. The manager should seek the advice of the Fire Safety Officer on this matter. 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 4 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 4 3 4 3 x Standard No 11 12 13 14 15 16 17 4 3 3 4 x x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 56 Monks Dyke Road Score 4 4 2 N/A Standard No 37 38 39 40 41 42 43 Score 3 4 3 x 4 2 x C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 6 Regulation 15(1)(2) Requirement Timescale for action 30/09/05 2. 20 13(2) 3. 42 23(2)(4) Care plans must express clearly how the service users needs are to be met, must be reviewed monthly and must show evidence of the service users involvement. The room in which medicines are 16/06/05 stored must be maintained at a temperature appropriate to requirements. (Administration and Control of Medicines for Care Homes and Children’s Services, Section 5.1; RPSGB) Fire exits must provide a safe 30/09/05 and efficient means of escape for all service users. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unity House The Point Weaver Road, Off Whisby Road Lincoln LN6 3QN 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 56 Monks Dyke Road C53 C04 S2678 56 Monks Dyke V230863 020605 Stage 4.doc Version 1.30 Page 24 - 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. 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