Inspection on 22/06/05 for 97 Monmouth Road

This inspection was carried out on 22nd 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 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

97 Monmouth Road 03/08/06

97 Monmouth Road 01/12/05

97 Monmouth Road 24/02/05

97 Monmouth Road 30/09/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 97 Monmouth Road Dorchester Dorset DT1 2DF Lead Inspector Marion Hurley Unannounced 22June 2005 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. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 97 Monmouth Road Address Dorchester Dorset DT1 2DF 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) 01305 266430 01305 250138 Leonard Cheshire Mrs Elaine Bernice Grant CRH PC - Care Home Only 3 Category(ies) of LD - Learning Disibility (3) registration, with number of places PD - Physical Disability (3) 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 24 February 2005 Brief Description of the Service: 97 Monmouth Road is a care home registered to provide care and accommodation to three people who have learning disability. The home is one of seven similar services in Dorchester that are owned and operated by the Leonard Cheshire Foundation, a ‘not for profit’ organisation providing services to people with disabilities. The registered manager is Mrs Elaine Grant, who is based at the Provider’s local office in Alexandra Road, Dorchester. The property is a semi-detached house, located in a quiet residential street, close to Dorchester town centre. All service users have single bedrooms, and share the communal lounge, dining room, kitchen and bathroom. The home has a pleasant garden to the rear. The home is staffed 24 hours a day, with usually two staff during the day and one member of staff on duty in the evening and sleeping in at night. Day activity programmes are arranged for the service users, which include leisure and community activities. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection has been undertaken as part of the statutory inspection process in accordance with the Care Standards Act, 2000. Monmouth Road was assessed according to the Care Home for Adults (18-65) National Minimum Standards. The overall time spent to complete the inspection process was a total of five hours, two of which were spent at the Home. In the course of this inspection both the Registered Manager and two members of the staff team were available. Three residents were present and participated and contributed in their individual ways. All records, documents and files were easily accessible on the day. From observations and discussions with staff it is clear there is positive job satisfaction and they genuinely enjoy the company of the residents. The residents are equally “comfortable” in the presence of the staff. This was a positive inspection of a service that continues to develop and aim for high standards of practise working side by side with residents with varying abilities and complex needs. The inspection process was assisted by the openness of the staff and management and the inspector was grateful for their time and commitment to the inspection. What the service does well: Staff work very positively with the three residents supporting and supervising each to lead active lifestyles, participating in a range of leisure and social events both locally and further a field. Residents are supported to live a normal pattern of life and are encouraged through participation and or observation to contribute to the daily decisions. Some residents behaviour is challenging and complex yet staff remain very positive and determined that no resident should be excluded from participating in activities or social events. Records indicated that staff monitor the health needs of all the residents. Monmouth Road offers a needs-led service through flexible routines and good staff relationships. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 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. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 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 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 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) None of these standards were assessed at this unannounced inspection. One recommendation from the previous inspection remains within the timescale for completion and will be fully assessed at the next inspection. EVIDENCE: 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 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, & 9 • • • • Care Assessments and Plans are in use for each of the residents. Residents are encouraged to participate and supported to make decisions in all aspects of their daily lives to enable them to retain as much independence as possible. Each plan incorporates risk assessments, which indicate where residents are particularly vulnerable and what action must be taken to safeguard each resident. The level of participation is very personal to each resident’s abilities and interests EVIDENCE: Three residents were met during the course of assessing the above outcomes. Assessments and support plans had been undertaken for all three residents and contained good information about each person’s needs and preferences. However, there was no evidence to show if any of the residents had been involved in formulating their own support plan and the Registered Manager and staff need in whatever way possible to involve the residents. The support plans set out how their current needs are met but do not clearly identify short /long term goals for each person. Not all the records had been reviewed within the last six months. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 Page 10 The risk assessments were generic and not specific to the individual person (in name only) and because they had not all been reviewed there was no evidence to indicate how that person’s behaviour may have changed and developed since the assessment was originally completed. All assessments/plans should be reviewed every six months to reflect any changing needs/abilities. The Registered Manager and staff need to consider ways to develop and produce a simple plan for each resident which through graphics and symbols may be recognisable to them and reflect their different activities. Observations of the two staff with the three residents indicated their understanding and excellent communication skills with the residents. Residents participate at varying levels in the running of the household. On the evening of this inspection all three were involved in clearing away the tea things, one took the rubbish out, another wiped up and the third helped to hoover. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 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) 13,&14, • All three residents have opportunities to join in local clubs and social events outside the home which enhance the residents’ local network and understanding of the community in which they live EVIDENCE: All the residents have varied weekly routines that include many activities away from the Home. These include attendance at Day Services, in addition to a wide range of leisure activities. One person regularly goes horse riding another has a weekly massage and one person helps at the local Playgroup. Evidence, qualifying the outcomes for these standards was obtained from reading the individual diaries kept for each person, support plans and through discussion with members of staff. Continuity is considered to be very important for the residents who seem to benefit from the familiarity of their routines 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 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 • Residents receive personal support based on their abilities, needs and personal preferences. This ensures staff deliver support, which is flexible, consistent and responsive to the residents needs. EVIDENCE: Residents are not able to take control of their own healthcare needs, however there were clear records which indicated staff ensure residents health and well being is monitored. Each resident has a written support plan which incorporates aspects relating to their health and general well being. A record of appointments and outcomes with health and other related professionals were available in the resident’s files. All residents are registered with local GP’s who staff stated were extremely helpful and understanding in their management of the residents’ complex health and emotional needs. Behavioural and emotional changes are monitored and staff work closely with Specialist Nurses and Consultants to establish realistic methods of supporting residents to participate in everyday activities safely. The outcomes for these standards were evidenced through discussion with staff and reading the records for one of the residents living at Monmouth Road Home. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 Page 13 All the residents rely on staff to totally manage, store, and administer their medication it is therefore essential that those staff completing any tasks relating to the residents medication must complete an accredited course in The Safe Handling of Medication. It is understood that Leonard Cheshire Homes, Dorchester have recently agreed a contract with Boots The Chemist and the first training course has been scheduled for July 2005. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 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 • The current group of residents would have difficulty in understanding the concept of a complaint. However, from observations it was evident staff listen and watch the resident’s different patterns of behaviour to ascertain and understand the wishes and views of each resident. EVIDENCE: Evidence to support this standard was obtained through discussion with both staff and the Registered Manager and from observing staff interact with the residents seen on the day of this inspection. The three residents all have different levels of comprehension and each has developed their own method of indicating their pleasure or apprehension. Staff have considerable intuitive knowledge and it would be advantageous for this to be recorded in the residents support plan. The plans contain some information about communication but when talking with the support staff their sensitivity and detail surpassed the written documents. No complaints or concerns have been raised since the last inspection. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 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 & 30 • • Monmouth Road is a family style home and is suitable for the needs of the people living there. On the day of the inspection the premises were clean, creating a safe and comfortable environment for both residents and staff. EVIDENCE: A partial tour of the premises and garden was completed. The communal areas are small though it is understood plans are being considered as to the best way to extend the kitchen area. The bedrooms reflected the hobbies and interests of the residents and had different colour schemes and layouts according to the needs and preferences of the resident. One bedroom is due for redecoration this summer and staff are helping the resident to decide upon a colour scheme. The home has a domestic style washing machine and tumble drier. The washing machine has a cycle, which will wash, to temperatures of 95 degrees centigrade. Any foul laundry is washed in dissolvable sealed “ red bags”. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 Page 16 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) 35 & 36 • All staff receive regular supervision and the support they need to carry out their jobs and this helps maintain a quality staff team working for the benefit of all the residents. The Leonard Cheshire Foundation offers appropriate training for staff to ensure they have the skills and competencies to meet the specific needs of residents. • EVIDENCE: Two staff, both support workers were met at the time of this unannounced inspection visit. Both stated they felt well supported by the management and other members of the staff team. They explained that informal supervision/advise was always available from senior staff whilst formal supervision was regularly conducted with their Manager. Notes of supervision sessions were checked. There is a comprehensive training matrix which indicates when staff have received training and when refresher training for mandatory courses is due. This validated previous information received during the course of this inspection. The Training Co-ordinator who is based in the Leonard Cheshire Administrative Office in Dorchester ensures information is kept up to date; this is then passed to the Regional Office to be included in the Regional Training Matrix. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 Page 17 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 &42 • • The Registered Manager is competent and experienced to run the home and is currently studying for NVQ level 4 in both management and care studies. At the time of this unannounced inspection safe-working practices appeared to be satisfactory ensuring a safe environment for both residents and staff as required. Not all staff are completing fire prevention training within the required timescales. All staff must undertake training every three months. EVIDENCE: The Registered Manager has created an open and inclusive atmosphere within the Monmouth Road Home and on the day of this inspection visit the two staff, Manager, and three residents were confident and happy in each other’s company. The delegated member of staff for Health & Safety must ensure must ensure all staff receive fire prevention training every three months. At the time of this inspection this issue was being addressed. 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 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 x x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 x x x Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 97 Monmouth Road Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 2 x D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 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 23 Regulation 13 Timescale for action All staff must receive appropriate 31st October, training in physical intervention and restraint. At the time of this 2005 inspection 50 of staff have completed training. Incidents of physical intervention/restraint must be recorded in detail and in a format which can be easily monitored by Management. All staff must receive regular refresher training in the Protection of Vulnerable Adults. The home must establish and 31st mainatin a system for reviewing October, and monitoring the quality of 2005 care provided by the home and where possible invovling residents or their representatives. The Registered Manager must 31st make arrangements for October, reveiwing fire precautions.All 2005 staff must receive three monthly fire prevention training . At the time of this inspection this requirement was being addresed but not completed. Requirement 2. 39 24 3. 42 23 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 Page 20 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 6 Good Practice Recommendations The individual care/service user plans need to be written based on the principles of Person Centred Planning and should include a record of the residents short and long term goals and acheivements. The individual care/service user plans need to be written based on the principles of Person Centred Planning and should include a record of the residents short and long term goals and acheivements. 2. 9 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole Dorset BH17 0NF 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 97 Monmouth Road D55 S26755 97 Monmouth Road V227802 230605 Stage 4.doc Version 1.30 Page 22 - 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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