Inspection on 06/09/05 for Casterbridge House

This inspection was carried out on 6th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Casterbridge House 29/08/06

Casterbridge House 16/02/06

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 MIXED CATEGORY MAJORITY OLDER PEOPLE Casterbridge House 753 Dorchester Road Upwey Weymouth Dorset DT3 5LF Lead Inspector Marion Hurley Unannounced Inspection 6th September 2005 09:30 X10029.doc Version 1.40 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.V249517.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 Older People and 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.V249517.R01.S.doc Version 5.0 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.V249517.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th March 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.V249517.R01.S.doc Version 5.0 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 Homes for Adults (18-65) & Older People, National Minimum Standards. The overall time spent to complete the inspection process was a total of seven hours, three of which were spent at Casterbridge House. All nine residents and three staff were present during this inspection. The residents chose not to specifically participate however all were observed side by side with staff throughout the visit. The Deputy Manager was available and provided information and access to all records requested. A partial tour of the premises and grounds was conducted with the Deputy Manager. Casterbridge House offers a homely domestic style residence for up to 10 people with varying abilities and needs. The premises and grounds are suitable for the current group of people and the facilities and services meet their individual and collective needs. From observations both staff and residents appear to enjoy a positive level of satisfaction with their lives and work and are comfortable and relaxed in each other’s company. The inspector was grateful for the time and support provided by residents, staff and the deputy manager throughout this inspection visit. Six requirements and five recommendations from the previous inspection have been carried forward as they were not specifically assessed at this inspection and remain listed under the 18-65 adult standards. Please note that the standards for this inspection have been based on both the younger and older persons National Minimun Standards which better reflect the group of people living at Casterbridge House. What the service does well: Casterbridge House has an established and stable staff team many of whom have worked at the home for several years. The Registered Providers, Dorset Residential Homes with the support of the staff maintain a relaxed and homely atmosphere whilst ensuring the National Minimum Standards are met. From discussions with staff and observations made throughout the inspection it was evident that the needs and wishes of the residents are paramount in the dayto-day running and managing of the Home. Some residents are quite vulnerable yet all are clearly encouraged and supported to be involved in all decisions affecting their daily lives. Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 6 Casterbridge House has a good training programme for staff and the records seen were well maintained. The quality of the resident’s Individual Profiles was good and the information was used to offer residents a range of activities, which reflected their abilities and interests. 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. Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were assessed at this inspection. No new residents have moved to Casterbridge House since the last inspection. The key standards will be assessed during the course of the next inspection. EVIDENCE: Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service Users, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8. • • Each resident has an Individual Life Plan, which reflects the support they require to ensure their health & personal care needs are met and managed on a daily basis. Each Life Plan is based on a series of assessments. EVIDENCE: Residents have individual Life Plans which detail their care needs and specify the action needed to be taken to meet their personal needs. Two files were looked at on the day of the inspection. Both contained full Life Plans, which Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 10 are written in the first person. Each plan is made up of various sections i.e. how to know and understand me; how I communicate. In addition to the Personal profiles each file contained specific information based on assessments and these included Daily Activities, Developing and Sustaining Relationships, Rights and Status, Choice and Control. Both sets of records were well presented and easy to read providing a good pen picture of the resident and their likes and dislikes and special interests. Each resident has a diary for appointments/ activities plus daily notes are kept in addition. Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service Users have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) 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. • The lifestyle in the home meets the expectations of the residents who live there providing a variety of experiences, which are age appropriate and meet their social and cultural needs and aspirations. EVIDENCE: Each resident has an individual weekly programme, which is broken down into daily activities which link to their likes and dislikes identified in their Personal Profiles. Participation in regular activities are then marked off on their individual Activity Checklist and provide the evidence of their achievements. Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 12 In the morning of the inspection some residents were joining in a music session whilst another was listening to music through his personal headphones, another was busy colouring some drawings. During the summer months residents have enjoyed going out to various locations often for a picnic e.g. Lulworth, Kimmeridge and further afield to the New Forest. Holidays have been arranged in discussion with residents and a variety of venues have been chosen including Devon, Cornwall and Wales. Groups of up to six residents at a time have participated in these holidays though generally smaller groups of three residents and three staff go together. Casterbridge has two vehicles and residents are not charged for the transport but are expected to pay for their annual holiday unless this would cause financial hardship. This standard was evidenced from discussion with staff and from reading resident’s records. The mid-day meal was served during the course of the visit and it seemed well presented and appetising (this standard was not fully assessed at this visit). Ample supplies of fresh fruit and vegetables were in evidence and drinks were regularly provided. Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service Users feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed at this inspection and the key standards will be assessed at the next inspection. However, it should be noted there have been no complaints since the last inspection. EVIDENCE: Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 & 22 • • • • The location and layout of Casterbridge House is suitable to meet the needs of the residents currently residing there. Individual residents have the equipment they need to be independent with staff support. Those bedrooms viewed had been personalised with ornaments, photographs and pictures. The premises were clean and tidy and reasonably well maintained ensuring a safe environment except for one downstairs toilet, which was not accessible to residents due to continued moisture on the floor from a leaking tank. Please note since the date of this inspection this has now been rectified. DS0000020436.V249517.R01.S.doc Version 5.0 Page 15 Casterbridge House EVIDENCE: Throughout the home there was evidence of aids and equipment for the residents use i.e. hoists, wheelchairs and bath aids. Those bedrooms viewed on the day of the inspection, had been personalised and adapted to meet the resident’s needs and wishes. None of the current group of residents has chosen to retain a key to their bedroom. These decisions have been made with staff who have based their judgement on fully completed risk assessments. Both the ground toilet and bathroom would benefit from being refurbished both are currently functionally but just dated in design and style. Storage space for large aids is difficult to remedy in the short term. The large main hallway is partly used for storage of wheel chairs and as a result was not especially welcoming. Facing the front door was a bookcase with the Pharmacy return bags and Mar charts. This aspect of the environment lets down the rest of the premises, which has an overall homely feel and atmosphere created by the staff and residents. Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed attic inspection and the key standards will be assessed at the next inspection. EVIDENCE: On the day of this inspection the Deputy Manager had overall reasonability for Casterbridge House and was working with two care Assistants. The Deputy Manager provided the very comprehensive Casterbridge House Training Matrix for Mandatory Training. This clearly illustrated the comprehensive training completed and the dates when the next training session was due. Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 On the day of this unannounced inspection all records relating to health & safety issues were checked and there was sufficient evidence from these records to demonstrate that safety tests were being carried out within recommended timescales. Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 18 EVIDENCE: On the day of this unannounced inspection all records relating to health & safety issues were checked and there was sufficient evidence from these records to demonstrate that safety tests were being carried out within recommended timescales. Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 x 3 x 4 x 5 x 6 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x ENVIRONMENT Standard No Score 19 3 20 3 21 2 22 x 23 x 24 x 25 2 26 x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 x 33 x 34 x 35 x 36 x 37 x 38 3 Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 (1)(2 Requirement Timescale for action 31/12/05 2 YA7 12(2) Schedule 3(i) 3 YA39 13(2) 4 YA39 24 Individual plans of care must demonstrate the process of consultation with the service user and/or where appropriate, their representative. (OP NMS 13) Following consultation, individual 31/12/05 plans must demonstrate the way in which service users are able to communicate their needs and make decisions about the care and services they receive. Where rectal preparations are 31/12/05 prescribed for ‘as required’ use, there must be a written management plan for each service user including the dose, the time allowance between the start of a seizure and administration, the frequency of any subsequent doses, when a GP should be called, when the emergency services must be called and multi-disciplinary agreement. (OP NMS9) The registered provider must 31/12/05 ensure that effective quality assurance and quality monitoring systems, based on seeking the DS0000020436.V249517.R01.S.doc Version 5.0 Casterbridge House Page 21 views of service users, are in place to measure the success in meeting the aims, objectives and statement of purpose. (OP NMS33) 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 YA2 Good Practice Recommendations The homes’ use of formal assessment tools such as ‘Roper, Logan and Tierney’ should be included in the admissions policy. (Older Person NMS 3) This recommendation was not assessed so is repeated for examination at the next inspection The registered providers should consider presenting information in formats that may be more easily understood by service users (OP NMS 2) The outcome of RAS assessments should be translated into specific needs and addressed with individual support plans. (OPNMS 13) This recommendation was not assessed so is repeated for examination at the next inspection It is recommended that consideration be given to the main entrance hallway to ensure it reflects a homely environment (OP NMS 16) It is recommended the ground floor toilet and bathroom are considered for refurbishment to ensure the facilities meet the needs of the residents. (OPNMS 33) Please note work was in hand at the time of this inspection to rectify this problem. 2 3 YA5 YA15 4 YA25 5 YA27 Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 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. Extracts may not be used or reproduced without the express permission of CSCI. Casterbridge House DS0000020436.V249517.R01.S.doc Version 5.0 Page 23 - 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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