Inspection on 16/02/06 for Casterbridge House

This inspection was carried out on 16th February 2006.

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

Casterbridge House 29/08/06

Casterbridge House 06/09/05

Casterbridge House 10/03/05

Casterbridge House 02/11/04

Casterbridge House 12/01/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Casterbridge House 753 Dorchester Road Upwey Weymouth Dorset DT3 5LF Lead Inspector Marion Hurley Unannounced Inspection 16th February 2006 15:00 Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 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 Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 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. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Casterbridge House Address 753 Dorchester Road Upwey Weymouth Dorset DT3 5LF 01305 813466 01305 815282 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) Dorset Residential Homes Mrs Sally Buckley Care Home 10 Category(ies) of Learning disability over 65 years of age (10) registration, with number of places Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: Casterbridge House is a Registered Care Home providing personal care for up to 10 people who have learning disabilities and additional physical disabilities. The home is operated by Dorset Residential Homes, a registered charitable trust that operates a number of care homes in Dorset. Located on the northern outskirts of Weymouth, the home is a short journey from the town centre. There are also local shops, pubs and a post office near to the home. An adapted multi person vehicle is available and the home is also on a main public transport route. The property is a large detached 2-storey house, which has been extended and adapted to meet the needs of people with physical disability. There are 2 single bedrooms and 4 double bedrooms for service users; one of the double bedrooms has en-suite facilities. The rear garden is accessible to all service users. The home is staffed by registered learning disability nurses and support workers on a 24-hour basis. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 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. Casterbridge House 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 six hours, two of which were spent at the home with residents and staff. During the inspection records related to the specific standards assessed were checked. The inspection process was assisted by the openness of the staff and the inspector was grateful for their time and commitment to the inspection. Requirements identified in previous inspections have been met. What the service does well: What has improved since the last inspection? The hallway has been rearranged and now provides an attractive and welcoming area into the home. New stair and first floor carpets have been fitted. Requirements issued at a previous inspection have all been met. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 Page 6 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. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 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 Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 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 • All residents are full assessed prior to admission to ensure the home can effectively meet their needs. EVIDENCE: All residents’ are fully assessed prior to their placement at the home. The assessments are comprehensive and holistic and involve the residents and their families. In addition staff gather assessments and plans from multiagency professionals known to the resident. The records of the most recently admitted resident were read and provided a real picture of the person’s needs, abilities and their preferences. The assessment identified the special aids and adaptations required to ensure the resident’s safe moving and handling. The registered manager said they ensure all aids and adaptations are in situ in the home prior to the resident moving in. The registered manager generally tries to meet the prospective resident in an environment, which is familiar to the resident and on this occasion met with the prospective resident at their day services. As a matter of good practice a series of visits for both family members and the resident were arranged for some prospective residents this may include a sleep over. A record of all contacts is kept during the transition / induction period. Staff said that the most recent resident to move into the home appeared to have settled well and certainly on the day of this inspection visit looked Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 Page 9 cheerful and quite relaxed and at home. The procedure for the person’s admission was thoroughly recorded and verified the discussions with staff. Residents in the main communicate through various forms of non-verbal communication and body language and from observations during this inspection visit it was clear that residents were relaxed and happy in the staffs’ company. Staff appeared highly knowledgeable about the needs of individual residents and their interaction with the residents was age appropriate and appeared caring. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 Page 10 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): The key standards were assessed at the last inspection and the work being undertaken at that time to meet the previous requirement has now been fully completed. All residents have Life Support Plans, which identify the services and facilities provided to meet the residents on going and changing needs. EVIDENCE: Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 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 the following standard(s): 13, 15, 16 & 17 • Residents live ordinary lives in the community seeing family and friends as they wish joining in activities that they enjoy. • Residents are provided with a menu that is nourishing meeting their needs and catering for their individual preferences. EVIDENCE: Residents are linked in groups of 3 or 4 and are supported by a team of 5 or 6 support workers. From reading Life Support Plans and in discussion with staff residents are involved and consulted about all aspects of home life. Residents are encouraged to make decisions and choices for themselves and where this may not always be possible, staff make informed choices based on their indepth knowledge of the individuals and information previously provided by relatives or significant others. Residents are helped to participate in tasks around the home if they want to. No residents attend day services but staff offer activities arranged around and in accordance with the residents individual wishes and interests. Staff said that on some occasions residents seem to like doing and sharing things as a Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 Page 12 group i.e. going to the theatre, cinema trips and in the summer picnics are very popular. A reflexologist regularly visits and was at the home working with residents individually during this inspection. Staff support residents to maintain contact with their relatives and on their behalf send letters and postcards to help the relatives and resident keep in touch. Six of the residents at the home have lived together for over ten years and are friends, two other residents moved from Bridport and will ask each other on outings. On the whole the household is quite a self-contained group of friends living together. Mealtimes are flexible in accordance with daily activities and, if necessary individual arrangements. Residents are involved in decisions about the type and content of meals and the menus are regularly discussed altogether on Saturday afternoons. To help residents participate recipes books and picture cards are used to encourage residents to point to what they would like. The menu always has an alternative and the records of all meals consumed are written in the resident ‘s Life Support Plan in the Menu Choices section. Staff said meals are enjoyed and the different patterns in meals are used to help residents distinguish between the weekends and weekdays e.g. on Saturdays residents enjoy a brunch with often a “take away” in the evening. A roast diner is generally cooked on Sundays. All staff take turns to do the shopping, preparing and cooking the meals. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 • The systems for ensuring the safe handling and administration of the residents’ medication are thorough. EVIDENCE: Medication administration sheets (MAR sheets) were examined and found to be in order. Photographs of all the residents are with the MAR charts and also small photographs have been added to the MDS packs. DRH has comprehensive policies and procedures for the management of residents’ medication and it was clear from checking the records and storage that the procedures were being carefully followed and implemented at the home. Each resident has a medication profile and these described how and why medication is administered and key side effects. These are reviewed annually with the health check undertaken by the GP/consultant. The outcomes of risk assessments have determined that none of the residents are able to have control of his/her medication and any in use is totally controlled by the home. Medicines were seen to be stored securely in a locked cupboard. A clear audit trail of medicines received and leaving the home was apparent. Homely remedies are recorded individually on the reverse of the residents’ MAR charts and the details are also added to their clinical notes. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 Page 14 The registered manager confirmed that only staff who have completed training handle medication. Staff studying for NVQ’s have individually completed assignments on the safe handling, storage and administration of medicines and this valuable work has been put into one main file and is now a useful resource in the home for all staff. This is a really good example of turning theoretical work into a practical resource for the benefit of all staff. The manager confirmed that the supplying pharmacist is due to complete an audit in March. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 • The home/DRH has procedures to deal with complaints or concerns. • Staff are aware of the action to take should a complaint or allegation of abuse be made. EVIDENCE: Dorset Residential Homes has comprehensive policies and procedures for dealing with complaints and any allegations of abuse. No complaints have been received since the last inspection. Staff completing NVQ training undertake specific study units on the Protection of Adults. The Registered Manager and staff demonstrated their knowledge and responsibilities to protect residents and understood the procedures to follow in such an event. Staff acknowledge that many of the residents are not able to comprehend the concept of “complaints” however staff displayed great intuitive knowledge and understanding of the different ways residents express their feelings and the registered manager and staff feel confident they would quickly perceive and react if they felt anything was troubling the residents. Staff are sensitive and have sufficient experience and work well as a team to ensure the welfare of the residents is foremost in their daily duties and responsibilities. Included in each resident Life Support Plan are the Resident’s Charter, and the Residents Guide to Abuse. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards were assessed and met at the previous inspection. EVIDENCE: Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 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 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): 32 ,34, & 35 • A well trained and committed staff group are meeting the needs of each individual resident in a sensitive and professional manner. • Staff are recruited in accordance with robust procedures and with both the residents’ individual and group needs central to the process. EVIDENCE: The home / DRH has an active training programme which means that staff have the necessary skills and competencies to care for the residents and meet their individual needs. There are currently 9 staff completing NVQ level 3 and a further member of staff will commence in March. There is a total compliment of 17 in the staff team with 2 qualified staff, 2 senior support workers and the remainder support workers. Staff spoken with said that they very much enjoy working in the home. They were observed speaking to the residents as equals and clearly had a good understanding of each resident’s needs. Relationships between staff and residents appeared to be relaxed and there was a warm and happy atmosphere in the home. Staff presented as being well motivated and committed to providing the best possible care for the residents. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 Page 18 Duty rotas examined, observations made and discussions with the Registered Manger confirmed that staffing levels are appropriate to provide a good level of care for the residents. Staff spoken with said they were able to give residents individual attention and spend quality time with them within and outside the home. The Registered manger has delegated a range of practical responsibilities to staff including training, continence care, and risk assessments, transport etc. This works well and staff said they both enjoy and learn from the additional responsibilities they complete in the home. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 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 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): 37 & 39 • The home is well run by a competent and experienced manager. • The interest and welfare of the residents is considered to be the foundation of the home and both staff and the manger endeavour to maintain the residents well being and safety at all times. EVIDENCE: The home is well run by an organised, caring and experienced Registered Manager who throughout the inspection demonstrated their qualities in managing both the welfare of the residents and the staff. Regular staff meetings and supervision all contribute to the effective teamwork observed throughout this inspection. Quality assurance and monitoring systems are ongoing. Regular staff meetings and supervision help monitor the quality of care provided and ensure staff maintain their competencies. The “responsible individual”/ representative for Dorset Residential Homes completes the monthly monitoring visits. Regulation 26 reports are comprehensive and extremely useful and provide a good picture of life in the home. Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 Page 20 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 3 ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 3 x 3 x 3 x x x x Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO 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 Casterbridge House DS0000020436.V279224.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole 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. 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