Inspection on 13/06/05 for Chatsworth Care - Dawson House

This inspection was carried out on 13th 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chatsworth Care - Dawson House 02/10/07

Chatsworth Care - Dawson House 08/09/06

Chatsworth Care - Dawson House 03/01/06

Chatsworth Care - Dawson House 26/11/04

Chatsworth Care - Dawson House 25/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Whitworth Lodge

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

CARE HOME ADULTS 18-65 Chatsworth Care - Dawson House 151 Stanley Park Road Carshalton Beeches Surrey SM5 3JJ Lead Inspector Peter Stanley Announced Inspection 13 June 2005 9:30am 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. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chatsworth Care - Dawson House Address 151 Stanley Park Road, Carshalton Beeches, Surrey, SM5 3JJ 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) 020 8395 5724 Mr G P Smith & Mrs Gabrielle Smith Ms Stella Anyokorit Care Home 6 Category(ies) of Learning Disability (6) registration, with number of places Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 26 November 2004 Brief Description of the Service: Dawson House was registered on 26 June 2003 and was inspected for the first time by the NCSC on 4 November 2003. The home is an attractive detached property set back from a fairly busy road in a residential area of Carshalton. The property is close to bus routes to Croydon and Sutton. The home offers very comfortable, well maintained accomodation with modern furniture in a clean environment. There are six bedrooms. The home is registered to support six people with learning disabilities. All rooms are single occupancy with en-suite facilities, with four rooms offering an en-suite showering facility and the other two have baths. The ground floor has a sizeable lounge, which overlooks the patio and garden. The home also offers a quiet room and a dining area. Access to the gardens is possible via the kitchen or through one of the service users patio doors. There is a portable phone for the use of service users if required. There are currently five service users at the home, with one vacancy.The home at present caters for four female and one male service user with learning disabilities, and is planning to admit another service user during 2005. Three of the present service users are described as having specific needs such as autism, asthma and sight impairment. One service user presents quite challenging behaviour. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, and was completed within one day. Both the registered provider, Gabrielle Smith, and the registered manager, Stella Anyokorit, were present throughout. The inspector agreed to the removal of one requirement from the last inspection. This related to the installation of radiator covers. The inspector agreed for this requirement to be removed following consultation with service users and the completion of individual risk assessments. The inspector was, as previously, impressed with the standard of care and support provided to service users, and with the open-ness and commitment shown by the home’s provider and manager in creating an enabling and inclusive home environment. There is one requirement and one recommendation outstanding from the previous inspection, with seven additional requirements and two further recommendations arising from this inspection. What the service does well: The home is able to demonstrate that the range of needs presented by service users are being appropriately assessed. The home has a thorough and ongoing process of assessment and review in place. This involves the service user, his family, and the care manager, and focuses comprehensively on the range of care and support needs presented. The home is able to demonstrate that it has the capacity to meet service users’ assessed needs, with service users’ health, personal and social care needs being set out in an individual plan of care. Staff are provided with the training, support and knowledge base required with which to meet the needs of this service user group. Service users are assisted to participate fully in the day-to-day life and routines of the home, and are supported by staff in making decisions for themselves in their daily activities. Staff work with service users in an enabling Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 6 and client-centred way, with service users being consulted regarding matters which affect them and their lives within the home. Service users are thoroughly assessed regarding potential risks to their health and safety, and are enabled to take responsible risks wherever possible. Service users are being encouraged and enabled to develop personal and independent living skills, and have opportunities for accessing appropriate education, training and work experience. Service users are being provided with a wide and varied range of opportunities for participating in recreational and leisure activities, and have extensive contact and links with the local community. The home actively encourages service users to maintain family links and friendships both inside and outside of the home. The home demonstrates that it is addressing the eventuality of a service users’ ageing, illness and death in a sensitive and respectful way, and that it is able to provide appropriate support to service users who experience loss and bereavement. Service users live in an environment which is safe, well-maintained and adapted for people with disabilities. Service users have access to safe and comfortable facilities, including sufficient communal areas, bathrooms and toilets. Service users’ rooms were observed to be safe, comfortable and pleasantly decorated, reflecting service users’ personal identities, and being suited to their individual needs. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 7 What has improved since the last inspection? What they could do better: While, generally, service users are protected by the home’s policy and procedures, there is an outstanding requirement which must be met for all staff to receive accredited medication training. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 8 Generally, the home’s policies, procedures and practice indicate that service users are being protected from abuse and are living in a safe environment. However, in order to raise the awareness of staff to the local multi-agency adult protection procedures, a requirement is made for all staff to attend Sutton’s vulnerable adult training. Generally, there are sufficient aids and adaptations within the home. However, given the decline in one service user’s mobility, an occupational therapist assessment is required to ensure her safety with showering and in the home. While staff are receiving a fairly comprehensive induction and training programme, there is a need for specific training in certain key areas (Equality and Diversity, Anti-Discriminatory Practice, and Challenging Behaviour), and for the target of 50 of staff, to become qualified to NVQ Level 2 by 2005, to be met. Generally, service users are being protected by appropriate recruitment policy and procedures, and the completion of the necessary recruitment checks. One newly recruited staff member is awaiting a CRB certificate, but is working under the supervision of an experienced staff member until such time as this has been received. A POVA check has been completed. A copy of the CRB certificate, once received, must be forwarded to the CSCI. The health, safety and welfare of service users and staff are being appropriately promoted and protected, with safety checks and certification being in place. Fire safety training is, however, overdue and must be updated. 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. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 9 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 Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 10 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) 1, 2, 3, 4 and 5 Prospective service users are provided with the information they require, and the opportunity to visit and stay overnight, before deciding whether the home is likely to meet their needs. The home is able to demonstrate that the range of needs presented by service users are being appropriately assessed. Which should give the service users confidence that the home will meet their needs and aspirations. Each service user is provided with a service agreement. This is written in a format which is appropriate to the communication needs of the service user. EVIDENCE: The home’s Statement of Purpose is very comprehensive and meets all the requirements detailed in this standard. This has been recently amended so as to clarify that the registered manager has now obtained her NVQ Level 4 and the RMA (Registered Managers Award). Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 11 The Service User Handbook has been reviewed since the last inspection and provides an appropriate format (using pictures) for assisting the understanding of individual service users. The homes admissions policy is for the home’s manager or owner to ensure compatibility with other service users living at the home. The procedure involves visiting the prospective service user, completing their own assessment and requesting psychiatric or psychological reports where necessary. Wherever possible, the home tries to involve the care manager or close relative as an advocate, or seek an independent advocate from within the local area. The inspector examined two service user files and found that they included the relevant evidence of care management assessments, details of the service user’s history, the home’s assessments of needs, together with risk assessments, care plans and service user plans. Reviews had been completed within prescribed time-scales. Review notes indicated that there was positive feedback from care managers and relatives regarding the home’s capacity to meet the service users’ assessed needs, and confirmed that this home is achieving its stated aim of providing quality residential care based on a holistic approach to meeting needs. Another file was examined. This related to the planned admission of a service user which the NHS funding authority did not finally approve. All relevant assessments, risk assessments and supporting documentation were in place, together with a record of contact and visits. The home invested a great deal of time and effort in planning for this placement and followed procedures correctly, involving the service user, his family, and the care manager fully in the process. Since the first inspection of the home, a training programme has been put in place. This includes Vulnerable Adult Awareness, Autism Awareness, and Challenging Behaviour. The home presently has five service users, three of whom have specialist needs, and another who has exhibited challenging behaviour. The homes Statement of Purpose refers to Referrals and Admissions following the homes policy. Once a prospective service user has been assessed, and found to be compatible with others living at the home, he or she is encouraged to visit the home, then stay overnight, followed by another possible overnight stay, and culminating in a weekend stay. This process is designed to enable the prospective service user to become familiarised with the home prior to making a decision on whether to move in on a permanent basis. The Manager has confirmed that the service user, his/her nearest relative, and care manager or advocate, are fully consulted and involved in the process leading up to admission. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 12 The home does not accept any unplanned or emergency admissions. A contract is developed and agreed with the prospective service user and his/her nearest relative, care manager or advocate, with a copy signed by the service user or his/her representative, placed on his/her file. In keeping with a recommendation from the last report, the contract has also now been written in a format, using pictures and symbols, which assists the service user’s understanding of its contents. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 13 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, 8 and 9 Service users have their health, personal and social care needs set out in an individual plan of care, and are being fully involved in the care planning process. Service users are assisted to participate fully in the day-to-day life and routines of the home, and are supported by staff in making decisions for themselves in their daily activities. Staff work with service users in an enabling and client-centred way, with service users being consulted regarding matters which affect them and their lives within the home. Service users are thoroughly assessed regarding potential risks to their health and safety, and are enabled to take responsible risks wherever possible. EVIDENCE: Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 14 The inspector examined two service user files and found that reviews had been completed within the appropriate time-scales. Service user plans provide information evidencing how service users’ needs are being addressed, and the involvement of service users and their relatives/representatives in drawing these up. The registered manager confirmed that all service users have a sixmonthly review as well as a statutory twelve-month review. Service User Plans and Reviews are being signed by the service user or his/her representative. Service user plans are comprehensive and follow a person centred plan approach. These evidence service user involvement and the service user’s right to make decisions in the process. The plans describe how service users will meet aspirations and achieve goals. There is substantial evidence of service users’ right to make decisions being respected, whether this is in the choice of activities, the use of leisure, choosing clothing or in developing skills and interests. The inspector spoke to two service users both of whom indicated that their views and preferences are respected and that they are able to exercise choice in their day-to-day activities and routines. There are a number of mechanisms in place for involving service users in the running of the home. Service users attend weekly meetings. These are facilitated by a member of staff, and are attended by the Manager or Deputy Manager. Each service user has a key worker who consults on a one to one basis and provides individualised support. Service users are consulted in respect of their day-to-day routines, their choice of food, and their choice of activities. Service users also receive regular weekly visits from the home’s owner, who consults with and spends time in discussion with the service users and staff. There was, however, indication from the comments cards received that service users would like to be more involved in decision-making within the home, 4 of the 5 service users having ticked yes to this question. The inspector found little in the way of explanation as to why this might be and did not receive any subsequent feedback which in any way evidenced this. However, given the impression conveyed by the comments cards, the inspector recommends that the issue of service user involvement in decision-making is checked out by the manager within a service users’ meeting and individually, by the key worker with each service user. Feedback received should be recorded, and made available at the next inspection. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 15 Inspection of two service user files provided evidence of risks identified from risk assessments, together with risk management strategies agreed with service users. The inspector was satisfied that the home has set in place a risk assessment procedure which details the risks and level of risk to service users, together with risk management strategies. Service users potential for developing independence is encouraged and enabled wherever possible, subject to safe strategies for managing risks being in place. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 16 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) 11, 12, 13, 14 and 15 Service users are being encouraged and enabled to develop personal and independent living skills, and have opportunities for accessing appropriate education, training and work experience. Service users are being provided with a wide and varied range of opportunities for participating in recreational and leisure activities, and have extensive contact and links with the local community. The home actively encourages service users to maintain family links and friendships both inside and outside of the home. EVIDENCE: Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 17 Inspection of case files, and discussion with service users, indicated that users are developing their potential and acquiring relevant life skills. The inspector spoke to two service users and observed others with whom communication was difficult. This indicated that staff are supportive of service users and enabling in their interactions. One service user was observed to be assisting with laying the table for lunch. Another service user assists with the maintenance of the garden. Service users are encouraged to maintain their own personal hygiene, and assist with household chores. These include tidying their rooms, sorting their laundry, preparing hot drinks and snacks and assisting with cooking and meal preparation( (under supervision). The inspector discussed the opportunities being provided for service users’ involvement in education/ training and other activities. One service user attends a local community college twice a week, doing cookery and pottery, and attends a training and employment centre in Wimbledon, developing work skills and acquiring work experience. Another service user attends Sutton College of Learning for Adults twice a week doing a variety of courses. All service users are evidenced from activity programmes to be offered opportunities for activities such as art, beauty therapy, music and dance and attending a gym, at local education and leisure centres. Service users spoken to by the inspector indicated that they find the activities offered to be enjoyable and fulfilling. The home actively encourages service users to access community facilities such as the local shops, a nearby park and the local leisure centre. The inspector understands from the manager that service users are assisted to go shopping in Sutton or Croydon (for clothes buying), and to attend community events and fairs when these arise. Three service users attend a gymnasium every Wednesday. Service users also go out for lunch at a local café or pub at least once a week. Three of the service users attend a local church for services once a week. The home has its own minibus which is used for transporting service users to activities, and for occasional daytrips to places of interest. The home is also arranging a five-day holiday to the Isle of Wight Holiday Centre in July for all five service users and staff. There are a variety of leisure activities offered which are evidenced in the activity programmes and service user plans. Two service users attend the Cheam Day Centre where a range of activities are offered, including dramatherapy and music therapy. Service users are also able to access other activities at a local leisure centre including swimming and bowls. One service user enjoys playing pool and has joined a local snooker club where he plays pool with his key worker. Another service user has, within the last year, been attending a riding centre in Epsom one afternoon a week, an activity which the inspector understands has proved very rewarding for her. Some service users also have social contact and activity through attending the Monday Club or Gateway Club. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 18 The manager has advised that family and friends are encouraged to visit the home, with a small, quiet second lounge being set aside for visits (if this is preferred to the service user’s bedroom). Service users are enabled to visit family at home for occasional weekends. The home has a portable phone which service users can use in their bedroom to make phone contact when required. Feedback from relatives comments cards was very positive, and indicated that relatives are kept well-informed and are made to feel welcome when they visit the home. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 19 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) 20 and 21 The home has a clear policy and procedures in place for the receipt, recording, storage, handling, administration and disposal of medicines which provides service users with the assurance that they are generally protected by the home’s policy and procedures. The home demonstrates that it is addressing the eventuality of a service users’ ageing, illness and death in a sensitive and respectful way, and that it is able to provide appropriate support to service users who experience loss and bereavement. EVIDENCE: Standards 18 and 19 were not assessed at this inspection. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 20 The home has a clear policy and procedures in place for the receipt, recording, storage, handling, administration and disposal of medicines. Medication is kept in a locked cupboard just off the office. The home employs the Boots blister pack system. All staff receive a comprehensive induction on the administering of medication to service users. Following induction training the staff member is observed by the manager on three occasions before being allowed to administer medication to a service user. A Boots pharmacist visits six-monthly and gives advice on medication issues, the last visit being on 11.2.05. Weekly checks on MAR sheets are being completed by the manager and deputy manager. A requirement in respect of Standard 20 remains to be met. This relates to the need for all staff to receive accredited medication training. The inspector has specified that no member of staff must administer medication until accredited training has been undertaken. The inspector was informed by the manager that those staff who have not yet completed accredited NCHA medication training, are enrolled on the next training course with NESCOT (North-East Surrey College of Technology). Two staff who have recently started have been placed on the waiting list. The inspector has viewed the home’s policy covering bereavement which is based on the NCHA (National Care Homes Association) policy. Information is obtained regarding the wishes of the service user and nearest relative when the service user is admitted to the home. Following a recommendation from the last announced inspection, staff have received training in loss and bereavement. This has proved beneficial in raising staff awareness in this area, and in supporting a service user who had suffered a family bereavement. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 21 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 and 23 The home has an appropriate and well-publicised complaints policy and procedure which provides clear information for raising complaints, and is available in an appropriate format for service users. This should give service users the assurance that their views are listened to and acted on The home’s policies, procedures and practice indicate that, generally, service users are being protected from abuse and are living in a safe environment. However, if this is to be maintained staff should received the appropriate training. EVIDENCE: The home has a complaints procedure that includes the relevant required information, including stages and times-scales, for the complaints process. A revised format has made this more comprehensible for service users. A complaints book has been established. No complaints have been recorded since the last inspection. Following discussion with the manager at the last inspection, there was a recommendation for a separate log to be maintained, to detail any concerns or positive feedback received. The inspector strongly recommends that this is acted upon, as this would provide a channel for any possible concerns to be identified and addressed. The home has its own Protection and Prevention of Abuse policy, and Whistle Blowing policy. The registered manager advised that the home has obtained Sutton’s Protection of Vulnerable Adult Policy, and that all staff have signed to indicate that they have read through the policy and procedure. The Manager confirmed that all staff have completed adult abuse awareness training, but that staff are still waiting to obtain places on Sutton’s multi-agency Vulnerable Adult training. A requirement applies. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 22 The inspector discussed an adult protection concern that was raised by the manager, and which involved an allegation which had been made by a member of staff who has since left the home. While the inspector was satisfied that the explanation of events that was evidenced in written submissions did not indicate any substantive basis to the allegation, and that no indication of any abuse had been evidenced, the inspector was nonetheless concerned that procedures had not been followed and that neither social services nor the CSCI had been notified of the allegation at the time it occurred. The registered provider and registered manager are reminded that any allegation of abuse towards a service user must, in future, be reported to the relevant agencies in line with the locally agreed adult protection procedures. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 23 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, 25, 26, 27, 28 and 29 Service users live in an environment which is safe, well-maintained and adapted for people with disabilities. Service users have access to safe and comfortable facilities, including sufficient communal areas, bathrooms and toilets. Generally, there are sufficient aids and adaptations within the home. However, given the decline in one service user’s mobility, an occupational therapist assessment is required to ensure that if there is a need for specialist equipment it is provided in order to maximise independence. Service users’ rooms were observed to be safe, comfortable and pleasantly decorated, reflecting service users’ personal identities, and being suited to their individual needs. EVIDENCE: Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 24 The home has been purposely refurbished for this client group and presents as suitable in meeting their needs. Each service user has access to either an en suite bathroom or shower room. The home is very well decorated, comfortable and well maintained with modern style furniture. Service users presented as comfortable with their surroundings and expressed their satisfaction with the facilities provided. All bedrooms are individualised and personalised by the service users, with all service users having a locked cupboard in their rooms. Each service user has a bedroom, which has more than reasonable useable floor space to meet individual needs and lifestyles, and which has en suite facilities. The inspector was shown two of the bedrooms by the service users. Both said that they liked their rooms. These reflected the personal tastes and interests of the two individuals. The home has pleasantly laid out communal areas which were being well used on the day of inspection. Service users indicated that they were happy with their environment. There is a living room, with a television, and another smaller, quiet lounge which opens out from the reception hall. The large kitchen includes a dining area. The home also has a large well-tended garden at the rear of the house, with a patio for the use of the service users. A recommendation for the home to develop an annual programme of planned maintenance and renewal for the fabric and decoration of the premises, has been implemented. This was shown to the inspector and evidenced that there is an ongoing programme in place. A requirement for the installation of radiator covers has not been implemented. Following consultation by the provider with the home’s service users, there was little indication of any wish for covers to be installed. With the completion of individual risk assessments, the inspector has agreed, subject to the need for regular, close monitoring of radiator temperatures, for the removal of this requirement. Generally, the home has sufficient aids and adaptations in place. The inspector was advised, however, that one service user is requiring more assistance with getting into the shower, with a decline in her ability to mobilise. This is evidenced in the service user’s care plan and daily notes. The inspector is making it a requirement for an occupational therapist to visit and assess the service user’s need for aids and adaptations in facilitating safe use of the shower, and regarding any other aids or adaptations that may be required in ensuring her safety and assisting her mobility within the home. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 25 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) 31, 32, 33, 34, and 35 Staff have clearly defined roles and responsibilities, and are sufficient in numbers to meet service users’ needs. While staff are receiving a fairly comprehensive induction and training programme, there is a need for specific training in certain key areas in order that service users and their representatives can be assured that their individual and joint needs are being met by appropriately trained staff. While, generally, service users are being protected by appropriate recruitment policy and procedures, and the completion of the necessary recruitment checks, this protection has been potentially compromised by the failure to obtain an up-to-date CRB check for a recently recruited staff member. EVIDENCE: Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 26 Standard 36 was not covered on this inspection. Inspection of staff files provided evidence of clearly defined job descriptions being in place. Policies and Procedures are reviewed annually, these last being reviewed in October 2004. Following a requirement from the previous inspection all staff have signed and dated a record to indicate that they have read and understood each policy and procedure that has been put in place and reviewed. The Manager advised that Staff Meetings are held on a monthly basis. There has been significant staff turnover during the last twelve months which has entailed the home losing a number of qualified staff. The registered manager advised that newly recruited staff being trained. One staff member has NVQ Level 2, with three other staff currently studying for NVQ level 2. The deputy manager holds NVQ level 3, an NVQ Assessors Award, and a PDC in Management Care, and is currently studying for an NVQ Level 4 and an RMA (Registered Managers Award). The home must aim to have at least 50 of staff qualified to NVQ Level 2 by 2005, for which a requirement applies. The inspector viewed the staff rota, and was satisfied that the staffing complement for the home met appropriate DOH guidelines, with 3 staff on each shift for 5 service users. 3 staff are on shift during the day, with 1 sleepin and 1 on-call at night. There is a training programme which ensures that all staff receive training on First Aid, Fire Safety, Food Hygiene, Moving and Handling, Health and Safety and Vulnerable Adults Procedures. The home has a satisfactory recruitment policy and procedure in place. This is based on equal opportunities principles and aims to ensure the protection of service users. The inspector examined the files of two new staff members files. Identity and recruitment checks were generally evidenced. However, the CRB (Criminal Records Bureau) certificate (dated 8.2.05) on file for one staff member was one which related to a previous employment, and was not an upto-date certificate dating from the commencement of her employment at Dawson House. The inspector understands that the staff member has received a POVA check and is working under the supervision of an experienced staff member. A copy of the CRB certificate, once received, must be forwarded to the CSCI. A requirement applies. The Registered Provider and the Registered Manager are reminded that portability is no longer acceptable and that an up-to-date CRB certificate must be obtained prior to the confirmation of any new staff appointment. The registered manager has set in place a training programme that ensures that all staff receive training in First Aid, Fire Safety, Food Hygiene, Infection Control, Moving and Handling, Health and Safety, Abuse awareness and Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 27 Vulnerable Adults Procedures. The manager advised that all staff have recently attended infection control training. NCHA courses are attended on a rolling basis. Training is being planned in autism by an NAS (National Autistic Society) accredited trainer, together with training in the use of Makaton. Person Centred Planning training with LB Sutton is also planned Following a recent incident, which entailed ‘racist comments’ being reported by a staff member, the inspector has identified a need for training for staff in the areas of Equality and Diversity, and Anti-Discriminatory Practice. Training in the area of Challenging Behaviour is also required, together with updated Fire Safety training. Requirements apply. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 28 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, 39, 40 and 42 The home is being run competently, and in the best interests of the home’s service users, with both staff and service users commenting favourably regarding the atmosphere in the home. The home is demonstrating more effectively, through the development of its quality assurance processes, that it is seeking the views of service users, relatives and professionals. This is helping to inform the home’s review of its ability to meet its aims and objectives, for which an annual quality assurance audit report has been introduced. The health, safety and welfare of service users and staff are being appropriately promoted and protected, with safety checks and certification being in place. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 29 EVIDENCE: The registered manager advised the inspector that she has now completed her training and obtained her NVQ Level 4 and the RMA (Registered Managers Award). The inspector has found that the manager has a good understanding of the needs of this client group and is very competent in her management of the home. The inspector has been impressed by the management approach within this home. The inspector’s observations, and the discussion which he has had with both service users and staff, evidences that service users needs are being well met and that there is a positive and enabling approach within the home. Service users presented as settled and happy within the home and able to participate in daily routines and decision-making. Staff feedback indicated that they feel well supported by management and that their training and support needs are being addressed. The requirement from the last inspection for developing a Quality Assurance audit has been met. An audit report has been developed which includes feedback from questionnaires. The questionnaire for service users has been presented in a suitable format for service users, and has been very well thought through and presented. This includes the use of Makaton and verbal prompts. Questionnaires have also been sent out to relevant care managers/ professionals and to the relatives/representatives of service users. The home’s policies and procedures are reviewed annually, these last being reviewed in October 2004. In line with a requirement from the previous inspection, there is now a full record in place detailing that staff have signed and dated to indicate that they have read and understood each policy and procedure reviewed. All maintenance records relating to health and safety are up to date. The home has a risk assessment in place. A requirement for radiator covers to be installed on all radiators has been removed, there having been consultation with service users and individual risk assessments completed. (see standard 24). All fire safety checks have been completed. Fire safety training must be updated for all staff. A requirement applies. Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 30 Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 31 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 2 x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score 2 3 3 2 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chatsworth Care - Dawson House Score x x 2 3 Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 x 2 x G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 32 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 YA23 Regulation 13(6), 18(1)(a) & (c) 13(4)a & c Requirement The registered manager must ensure that all staff attend Suttons one-day Vulnerable Adult training. The registered manager must arrange for an occupational therapist to visit and assess a service user who has experienced some deterioration in her mobility. There must be an assessment of her need for aids and adaptations in facilitating safe use of the shower, and regarding any other aids or adaptations to assist her safety and mobility within the home. An O.T report must be obtained and all recommendations implemented. The registered manager must aim to ensure that at least 50 of staff are qualified to NVQ Level 2 by 31.12.05. The Registered Manager must ensure that a new CRB certificate is obtained for a recently recruited staff member, and a copy forwarded to the CSCI. The registered provider must Timescale for action 1.10.05 2. YA29 1.10.05 3. YA31 18(1)a & c 19(1)b, Sch.2, No 7 31.12.05 4. YA34 1.11.05 5. YA35 18(1)a & 1.10.05 Page 33 Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 c 6. YA35 18(1)a & c 18(1)a & c, 23(4)a &d 18(1)c 7. YA35, YA42 8. YA20 ensure that training is provided for all staff in the areas of Equality and Diversity, and AntiDiscriminatory Practice. The registered manager must ensure that training is provided for all staff in Challenging Behaviour. The registered manager must ensure that updated training in fire safety is provided for all staff. The registered manager must ensure that all members of staff who administer medication have received accredited medication training. 1.10.05 1.9.05 Extended to 1.9.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA8 Good Practice Recommendations The inspector recommends that the issue of service user involvement in decision-making is checked out by the manager within a service users’ meeting and individually, by the key worker with each service user. Feedback received to be recorded and made available at the next inspection. The inspector recommends that the registered manager maintains a log to record any concerns expressed/actions taken, and positive feedback received. 2. YA22 Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 34 Commission for Social Care Inspection 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Chatsworth Care - Dawson House G53 S42620 dawsonhouseUI V181173 130605 stage4.doc Version 1.30 Page 35 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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