CARE HOME ADULTS 18-65
6 Durlands Road Horndean Waterlooville Hampshire PO8 9NT Lead Inspector
Tracey Box Unannounced Inspection 29th September 2005 09:30 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 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 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 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. 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service 6 Durlands Road Address Horndean Waterlooville Hampshire PO8 9NT 023 9259 1915 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) Robinia Care Group Ltd Miss Amy Jane Sanger Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 18th April 2005 Brief Description of the Service: 6 Durlands Road is a large , detached registered care home providing personal care, accommodation and support for four young adults with learning disabilities and complax needs. The home was opened in August 2004 and is set in a residential area on the outskirts of Horndean, on the A3 between Guildford and Portsmouth. The home is one of many owned and run by Robinia Care, a national company based in the South of england. 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five and a half hours, the manager, Amy Sanger and one care staff assisted the inspector. The people living at 6 Durlands Road prefer to be referred to as service users, therefore will be referred to as this throughout the report. The inspector witnessed good behaviour management system, which included clear boundaries and consistent and positive use of agreed sanctions and rewards, this enabled positive interacting between three service users and the staff who provided one to one support as they prepared to attend the scheduled activities for the day. One service user had attended their day placement activity. The inspectors looked at records and asked staff for their views of working in the home. The manager showed the inspectors the layout within and surrounding the home, which appeared clean and comfortable, providing a pleasant environment for the service users. What the service does well: What has improved since the last inspection?
The home has reviewed its statement of purpose to include all relevant information. Monthly regulation 26 visits are completed by the Responsible Individual, the Commission for Social Care Inspection receives copies of the reports. Soap dispensers and paper hand towels have been installed next to every hand wash basin. The home has a full complement of staff, Staff morale is high resulting in an enthusiastic workforce that works positively with service users .
6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 6 Additional funding from Social Services has resulted in service users receiving one to one staff support,(as reflected on the staff rota) this has ensured service users receive the support they require and has improved the atmosphere by reducing incidents and accidents within the home. Staff have attended Strategy for Crisis Intervention and Prevention S.C.I.P. training from the manager, who is trained to provide this training. The inspector received verbal confirmation from the company’s client finance officer that Robinia Care Ltd have stopped claiming each Service users’ Disability Living Allowance (D.L.A.) to cover the cost of transport, this came into effect 8th June 2005. The provider is required to develop a policy and procedure for the charges to service users for the cost of transport, and include the cost in the individual’s contracts. 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. 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 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 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 A comprehensive procedure for assessing the needs and aspirations of potential new service users is in place to ensure the service users and the homes needs are met prior to admission. EVIDENCE: The inspector looked at four service users file which included pre placement assessment forms which were completed by the service users, their parents and social worker. The information included educational and recreational wishes, likes and dislikes, general appearance of the service user and a manual handling assessments. Family/representatives and staff are invited to participate in the completion of the assessment to obtain as much information as possible. The manager explained that prospective service users are invited to spend a day at the home with their own care staff. The next stage of the assessment process involves the service user, their relatives and social worker meet with the manager of Durlands Road where they all discuss the assessment, and whether or not the service user wishes to live at Durlands Road, if the home is able to meet their needs. The service user’s place is confirmed by signing a contract-statement of terms and conditions of the home. The manager confirmed the information gathered at the assessment process is the basis for the individual’s care plan. The inspector saw this in all individual’s files. 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed at the previous inspection. EVIDENCE: These standards were assessed at the previous inspection. 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15,16 Service users participate in activities appropriate to their age, peer group and cultural beliefs, promoting appropriate personal, family and sexual relationships. Practices within the home demonstrate that individual rights and responsibilities are respected and recognised. EVIDENCE: The manager explained to the inspector that Service users are encouraged, in line with their care plan and risk assessments, to participate in social activities, both within the home and the community. Records of activities are recorded in the individuals care plan and daily records, these include visits to theme parks, cinema, discos and shopping. Staff also confirmed these are appropriate to the service users preferences. Care plans reflect the individuals cultural beliefs and individuals sexual preferences, the manager explained at present service users do not wish to partake in relationships, other than friendships outside the home. Should the need arise, service users would be fully supported and staff would follow the
6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 11 homes policy on personal and sexual relationships. The manager is aware of how to obtain support should it be required for any service user. The inspector witnessed the visitors book which detailed family and friends visits to the home. Staff reported there are no restrictions on visiting, unless stated in an individuals care plan. A copy of Service users rights and responsibilities are held in the service users guide, the home’s statement of purpose, and in each individual service users contract. The inspector received two comment cards which indicated that the service user “Did not wish to be more involved in decision making within the home.” 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Service users receive personal support in the way they prefer and require EVIDENCE: The care plans and risk assessments states how the individual wishes to receive their personal support and are reviewed on a monthly basis or as needs change. Two service user comment cards indicated that they agreed that they were well cared for by staff that treated them well and respected their dignity. Daily records comment on individuals daily activities, physical and emotional health and behaviour, records of visits to outside agencies, such as doctor, dentist, optician are kept on the individuals file, this enables the home to monitor and track the information recorded. 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed at the previous inspection. EVIDENCE: These standards were assessed at the previous inspection. 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed at the previous inspection. EVIDENCE: These standards were assessed at the previous inspection. 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Appropriately trained staff ensure individual and joint needs of service users are met. EVIDENCE: Throughout the inspection, staff listened to the service users, and responded appropriately to meet the individuals’ and joint needs. One member of staff who had recently started working at Durlands Road, stated they had completed induction training and Learning Disability Award Framework, which included training on, policies and procedures of the home, learning disability, epilepsy, syndromes relevant to the needs of the service users and communication. Staff are working towards their National Vocational qualification level 2 and 3 and the Certificate In Working with People with Learning Disabilities One staff member said “ I feel I have adequate training in order for me to carry out my job, I can just ask if I want training, I don’t have to wait until a meeting or my supervision.” Staff explained “we work well together as a team, during staff meetings we talk openly and share ideas and support one another, this helps us meet the needs of all service users.” One member of staff said “I feel we have adequate staff on duty to meet the needs of the service user.” The manager confirmed staffing levels are adequate, the inspector saw the duty rota which also confirmed this. 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39,42 The systems for service users consultation are good, with a variety of evidence that indicates service users views underpin all self monitoring, review and development by the home. The health, safety and welfare of service users are not fully protected. EVIDENCE: The manager circulates a service users survey, and the responsible individual completes monthly visits to the home, in which service users are consulted on their views of the home. Three Service users choose to attend the monthly service user meetings, minutes are taken and given to service users. The inspector noticed that the weekly menu had been planned by two service users, the manager confirmed this practice occurs weekly using pictures to choose meals. The manager confirmed quality issues are discussed on a one to one basis at staff supervision and within staff meetings. 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 17 The provider must improve the time it takes between the home reporting a fault and the fault being fixed. The inspector saw records showing that a fault with the staffs’ personal alarm was reported on the 11th August 2005, and was also reported to the Responsible Individual during their regulation 26 visit in August and September, and when the home received it’s annual Health and Safety audit, during this time the staff were at risk of being unable to attract attention of other staff within the home of they required it. At the time of the inspection the fault remained. The home had reported two other faults which have not been actioned, one was a fault with a communal toilet Therefore the provider is required to review it’s procedure for reporting and actioning maintenance issues. Four fire doors were wedged open with a chair, the manager explained this is to ensure staff can see service users when they are altogether in communal areas downstairs, the inspector saw a risk assessment, however the inspector requires the provider to install appropriate magnetic door release to each fire door. Staff receive adequate training on health and safety issues, as evident from the staff training plan, the inspector saw certificates for staff attending moving and handling training, first aid, food hygiene and Control Of Substances Harmful to Health. The home has risk assessments in place for the building and safe working practices for staff. Certificates showed the maintenance of services within the home were up to date. 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 18 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 X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
6 Durlands Road Score 3 X X x Standard No 37 38 39 40 41 42 43 Score X X 3 X X 2 X DS0000060861.V254687.R01.S.doc Version 5.0 Page 19 NO 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 42 Regulation 23(4)( c) (1) Requirement The provider must ensure each fire door is fitted with appropriate magnetic door release . Timescale for action 13/10/05 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 6 Durlands Road DS0000060861.V254687.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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