Inspection on 08/05/08 for An Darach House

This inspection was carried out on 8th May 2008.

CSCI found this care home to be providing an Excellent 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

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 An Darach House 22 School Lane North Scarle Lincoln LN6 9EY Lead Inspector Julie Western Unannounced Inspection 8th May 2008 09:30 An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service An Darach House Address 22 School Lane North Scarle Lincoln LN6 9EY 01522 866010 01522 866001 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) Kisimul Group Ltd Manager post vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability - code LD The maximum number of service users who can be accommodated is: 6 2. Date of last inspection Brief Description of the Service: An Darach is situated next to the school in the village of North Scarle, with facilities that include a shop, post office, pub and church. The property, formerly a private house, has been modified and is now registered to give care and accommodation for up to six residents with a learning disability. All six present residents came from Kisimul school in Swinderby and lived at first in a house within the school grounds, from where they relocated to North Scarle in August 2007. There are six en-suite bedrooms, one of which is on the ground floor, a large kitchen, dining room and living room. There is a large garden to the rear, with a patio and a large, fenced off fishpond. There is parking for several cars to the front of the property. At the time of the inspection the home confirmed that the weekly fees ranged from £335 - £550, depending on the assessed needs of the resident. Additional charges are made for services such as chiropody and hairdressing. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report is available in the manager’s office. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This key inspection was carried out over three hours and took into account any previous information held by CSCI including the home’s previous inspection reports, its service history, any pre-inspection questionnaires completed by the Manager including the Annual quality assurance assessment [AQAA] and any residents’ questionnaires sent to the home by the Commission prior to the inspection. The site inspection was unannounced and consisted of tracking a sample of residents’ care records and assessing the care given. Some policies and procedures were examined and some records concerning the safety of the home were also seen. Three residents, three care and ancillary staff and two visitors were spoken with. The Manager was present throughout the inspection. THEMATIC PROBE As part of this unannounced inspection, the acting manager was informed that a thematic probe would be undertaken looking specifically at information regarding safeguarding adults. The acting manager was asked a set of questions about this topic. Other information included the provider’s policies, procedures and staff training in safeguarding adults. These findings will be used as part of a wider study that CSCI are carrying out about safeguarding adults. Further information on this can be found on our website www.csci.org.uk What the service does well: The home is very well run, with a well trained and supported staff team. The staff provide good support for the people living there and work well together. Care plans are in good detail and assist the staff to meet all the needs of residents. The home is spacious, modern and decorated to a very high standard. There are plenty of activities for residents to join in, with regular outings and events, from which residents can choose. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 6 Staff involve residents in the running of the home at every opportunity and encourage them to be more independent, while at the same time making sure they are safe from harm. Arrangements to protect residents from abuse of any kind are robust. Relatives of the residents praise the way they are cared for; one wrote ‘I cannot imagine that he could have all his needs met as well anywhere else, and that includes home’. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have very good information about whether the home in order to make an informed decision about whether the home is right for them. EVIDENCE: All six residents previously lived at Kisimul school in Swinderby. They have lived together as a group at An Darach since 2002 and all transferred from the school with detailed assessments and care plans. There have been no new admissions since then and it is expected that they will remain together. The acting manager outlined the process she would follow if a vacancy arose and documents seen showed that there is a thorough referral and preadmission assessment process. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans give a very clear picture of residents’ needs. The staff group meets these needs with sensitivity and regard for residents’ privacy and dignity EVIDENCE: The care plans for the two residents selected contained detailed information that accurately reflected the residents’ support needs. Presentation of the care plans was excellent; they were easy to read and understand, providing new staff with information to gain a profile of the residents quickly. There were also excellent daily records, which were cross-referenced with incident records to provide very detailed information about residents’ daily lives. All Independent Plans of Care [IPC’s] are reviewed formally on a six-monthly basis, with social workers and parents invited to attend. There is also a review each month. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 10 All residents have a severe learning disability and are not able to fully participate in the review process, but care plans were signed and agreed with parents and placing authorities. Goals and aspirations were clearly recorded and measured. The AQAA stated that independence was encouraged wherever possible and records confirmed this. Most residents have autism and severe communication difficulties and staff have previously been observed to use a variety of communication methods to ascertain choices, including MAKATON signing [a form of sign language developed for people with a learning disability], PECS [Picture Exchange Communication System] and objects of reference [for example, using a cup to indicate that the person wants a drink]. Care plans also contained good information about residents’ individual communication needs. Staff were not available on the day of the inspection, having gone with the students to Grantham College for the day. The tutors at the college were spoken with by ‘phone and their observations were that staff communicated with residents sensitively and with regard for their dignity, allowing them freedom of choice wherever possible. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a wide range of activities for residents to participate in, led by the residents’ wishes. Meals are flexibly arranged to suit residents’ choices and preferences. EVIDENCE: Residents have a weekly activity timetable that is split into morning, afternoon and evening, although this can be flexible. Activities included computer work, swimming, horticulture, animal husbandry on the Kisimul school site and outings. Residents have sole use of a mini-bus and one resident has a motability car. The acting manager said that last year all residents had a holiday in caravans in Norfolk and this year they were going to Cornwall in August. Records and photographs confirmed this. One resident is taking part in the Race for Life this year. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 12 On the day of the inspection, two residents were staying with their parents and four were at Grantham College for the day, with the staff members, where they attended twice weekly. On the day of the inspection they were learning baking and pottery. Other interest and hobbies included ‘Klub AD’, an evening club for young people held at Kisimul School for An Darach House and its sister home, An Caladh in Washingborough. The club is self-funding. The home has its own cat and one resident has the responsibility for feeding and caring for it. The home is an accredited centre for the provision of the Award Scheme Development and Accreditation Network towards Independence [ASDAN]; all the residents participate in the ASDAN curriculum, which enables them to work towards specific goals and awards. Residents are supported to have regular contact with their relatives, by sending letters, telephoning or by visits, according to their wishes. One resident sends e-mails, using ‘widgets’ [symbols] instead of words. Records of contacts are kept in care plans. The menu is on a four-weekly rota, which enables the acting manager to check whether it is balanced. Staff members manage the cooking, assisted by residents if they wish. Care plans clearly showed the preferences of residents. On the days that residents went to the College, they had a pack-up lunch of their own choice. The acting manager explained that although healthy options were encouraged, staff respected individual choices. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health care needs of the residents are met by having an educated staff team who have received the appropriate training EVIDENCE: Care plans seen recorded all aspects of healthcare including visits to opticians, dentists, hospital consultants and GPs. All residents are registered with a local GP practice in a neighbouring village. All residents are currently mobile and three need prompting to carry out their own personal care, while three need assistance. Medication records were clear and the Boots blister pack monitored dosage system was used. Records showed that the pharmacist visited regularly and on the day of the inspection the pharmacist visited with the medication ordered. She said that the medication distribution and record-keeping standards at the home were very good. A list of staff members who have had the relevant training to distribute medication is displayed in the office. Records showed that all senior staff had attended a Safe Medication Handling course. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 14 An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The complaints procedure is clear and gives residents and their supporters the confidence that complaints and comments will be listened to. Residents are kept safe from harm by clear policies and procedures concerning safeguarding adults. Staff training ensures that staff are clear on the action to take in the event of this happening. EVIDENCE: The acting manager demonstrated a thorough knowledge of adult protection procedures and confirmed that all staff received training within the induction programme, together with regular updates. An ‘Adult Protection Response List’, giving very clear and concise guidelines, was displayed in the office for staff to read. Records showed that there had been no complaints since the home opened. There had been one concern from a parent regarding arrangements for residents returning from home visits and the acting manager showed that this had been addressed satisfactorily. There are robust arrangements for recording accidents and injuries and all physical intervention records documented what post-incident support the person and required. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. An Darach House offers a high standard of environment, where residents can live in comfort and safety. EVIDENCE: The residents moved to this house, which was formerly a private home, on 17th August. Externally, the house is in a good state of repair. Internally, the premises have been refurbished to create a modern, homely atmosphere. Residents were able to choose some of the furniture. Rooms were of a good size and well personalised; the acting manager said that residents cleaned their own rooms with assistance from staff. All rooms were en-suite and residents had been able to choose whether they wanted a shower or a bath. There was also a separate bathroom; this was locked on the day of the inspection. The kitchen was large and open-plan, with seating. There was a separate dining room and large living room. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 17 Outside there was a large garden with patio, summerhouse, large lawn and at the bottom, a fishpond which was well fenced off. The patio needed some attention as it had gaps between the flags and the acting manager said that this was already part of the ongoing maintenance plan. The Kisimul group have their own health and safety manager who visits and carries a full risk assessment of the premises as well as a monthly inspection and there is also a maintenance team to carry out any repairs and renovations. A relative wrote ‘the new house is wonderful’ in a recent questionnaire. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent EVIDENCE: Staff work in teams of three, with two night teams. There are usually three staff members on duty, reflecting the needs of the current support needs of residents. In addition, the acting manager was present five days a week. In a recent questionnaire a resident wrote ‘there is a good professional service from the staff’. Staff files were very well organised, being divided into Human Resources, Support and Supervision, Training and General Correspondence. They contained evidence of CRB checks, recruitment and induction procedures. It was suggested that up to date photographs of staff members was placed on files. There are excellent training opportunities for staff and each of the day staff teams has a training day every three weeks, with night staff fitting in around these. The Kisimul group employs a training manager who oversees the training programme. In addition the acting manager keeps a training matrix on the computer and updates it regularly. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 19 Each member of staff has a detailed training profile, outlining all training undertaken. Training records showed that all mandatory training was completed, with staff also being trained in specialist issues for people with severe learning difficulties. Five staff members have achieved the National Vocational Qualification [a nationally recognised qualification] at level 3; most have level 2. Staff supervision records showed that formal supervision was every two months and from these a rolling training plan was developed to suit the training needs of staff. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed and the health, safety and welfare of the residents are promoted. The views of residents and their supporters are listened to. EVIDENCE: The home is currently operating with an acting manager; the day before the inspection interviews had been held and it is expected that the vacant post will be filled from these. The acting manager has worked with the Kisimul group for 10 years and was manager of An Darach house for two years, before being appointed as group support manager. She has the Registered Manager’s award and a degree in psychology. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 21 The support manager is normally responsible for carrying out monthly monitoring visits to the home and will be responsible for he induction of the new manager. A questionnaire, using symbols, in used to gauge the satisfaction of the residents and recent questionnaires seen all provided positive feedback. The acting manager also conducts weekly documented checks relating to the day-to-day running of the home. Maintenance and health and safety documents were not inspected in detail but there was evidence of regular fire checks and environmental checks to maintain a safe environment for residents. Overall, documentation and policies and procedures were very well organised and kept. Letters of satisfaction from relatives included ‘An Darach has great strengths and gives quality care and social support to my son’ and ‘he is as happy as he could ever be’. An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 23 N/a 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. Standard Regulation Requirement Timescale for action 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 An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI An Darach House DS0000070574.V364156.R01.S.doc Version 5.2 Page 25 - 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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