CARE HOME ADULTS 18-65ClosereachGeorge Lane Plympton St Maurice Plymouth Devon PL7 3LJLead InspectorMandy Norton Unannounced Inspection 26th January 2006 10:00ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 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 organisationReader InformationDocument 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.ukInternet addressClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 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.ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 3 SERVICE INFORMATIONName of service ClosereachAddressGeorge Lane Plympton St Maurice Plymouth Devon PL7 3LJ 01752 348348 01752 347555Telephone 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)Broadreach HouseMr Gerard Dooley Care Home 17Category(ies) of Past or present alcohol dependence (17), Past or registration, with number present drug dependence (17) of placesClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 4 SERVICE INFORMATIONConditions of registration: 1. 2. Male only Age 18yrs Date of last inspection2nd September 2005Brief Description of the Service:SUMMARYThis is an overview of what the inspector found during the inspection. This was short unannounced inspection to assess the core standards not assessed during the last inspection. It was carried out with the administrator and some telephone help from the administrative office at Broadreach House (Closereachs head office) Residents were involved in a variety of activities during the inspection and 3 were spoken to on an individual basis. Service User comment cards were sent to the home to distribute to all residents who could then choose whether to complete them or not. A tour of the home took place and completed Service User Comment cards returned were also used to inform the following report. One requirement and one recommendation were made following the inspection.What the service does well: 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.ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 7 DETAILS OF INSPECTOR FINDINGSCONTENTSChoice of Home (Standards 15) 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 InspectionClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 8 Choice of HomeThe 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): None of these standards were assessed during this inspection. EVIDENCE:ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 9 Individual Needs and ChoicesThe 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): None of these standards were assessed during this inspection EVIDENCE:ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 10 LifestyleThe 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): 15 and 16 The staff have a good understanding of the residents cultural, social and recreational needs and the importance of maintaining contact with family and friends (within the restrictions of the therapeutic programme). The staff promote independence and personal choice (within the restrictions of the therapeutic programme). EVIDENCE: Residents are able to go out into the community (some restrictions apply, these are fully discussed with the residents on an individual basis) to meet a variety of people. The contracts issued when a resident enters the home clearly state the restrictions that apply during the programme. Most of the residents share rooms with others and are encouraged to keep their environment clean and tidy. Residents do not have keys to their rooms (this is agreed as part of the programme).Closereach DS0000003532.V262461.R01.S.doc Version 5.0 Page 11 They carry out household tasks (therapeutic duties) during their stay at Closereach. These are decided on communally and the list of duties is displayed on the notice board. Residents post is sometimes opened in front of a staff member, the reasons for this are clear in the Service users Guide. During the inspection residents were seen talking to a variety of staff about different issues.ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 12 Personal and Healthcare SupportThe 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 homes 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): 19 Residents have a clear consistent approach and care planning system in place that provides staff with sufficient information to satisfactorily meet the residents needs. EVIDENCE: Residents are given supported and facilitated to take control of and manage their own healthcare. They are able to visit the GP or any other health professional on their own and attend Alcoholics/Narcotics Anonymous regularly. They are issued with a bus pass when they enter the home but transport can be provided if necessary. The health of the residents is monitored and if the staff have any concerns about a resident they discuss it with the resident and can contact the local GP or a nurse at Broadreach for advice.ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 13 Concerns, Complaints and ProtectionThe 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): None of these standards were assessed during this inspection EVIDENCE:ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 14 EnvironmentThe 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): 24 The standard of the environment within the home is satisfactory providing residents with a comfortable place to live. EVIDENCE: The manager said that some internal decoration had taken place since the last inspection. A tour of the home confirmed that the general cleanliness of the house was not as good as in previous visits. There was a lot of dust around the house, a lot of dirty marks around door-handles and the area around the public telephone was very `grubby. The toilets were quite clean but the showers had black areas around the sealant where they have not been cleaned adequately. The residents rooms seen were tidy and seemed to be quite clean, although they were not all examined in detail. The tap on the sink unit in the ground floor toilet was loose.ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 15 StaffingThe 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 homes 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): None of these standards were assessed during this inspection. EVIDENCE:ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 16 Conduct and Management of the HomeThe 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 homes policies and procedures. Service users rights and best interests are safeguarded by the homes 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): 39 and 41. A comprehensive regular review is carried out about aspects of performance through a programme of self review and consultations that include seeking the views of residents, relatives, staff and other external stakeholders. The home does not have a duty rota to record who is on duty or on call compromising the safety of the residents. EVIDENCE: Broadreach use a comprehensive quality assurance system based on seeking the views of the residents, families ( where possible) and other stakeholders. The business development manager talks to care managers throughout the country who have placed their clients at Closereach and his feedback also informs the quality monitoring system. The results of questionnaires are fed into a data system that analyses the responses and produces results/information about their performance that is available to residents, stakeholders and the CSCI. Future training plans andClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 17 developments are informed by the results of the ongoing quality assurance system. Residents are asked during their stay and at the end of their stay how they feel Closereach has met their needs. There is no recorded duty and on call rota within the home. The ad hoc arrangements seem to work but it is unclear how the residents know who is on duty or on call at any given time.ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 18 SCORING OF OUTCOMESThis 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 applicableCHOICE OF HOME CONCERNS AND COMPLAINTSStandard No 1 2 3 4 5ScoreX X X X XStandard No 22 23ScoreX XENVIRONMENTINDIVIDUAL NEEDS AND CHOICESStandard No 6 7 8 9 10ScoreX X X X XStandard No 24 25 26 27 28 29 30STAFFINGScore2 X X X X X XLIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17Standard No 31 32 33 34 35 36ScoreX X X X X XCONDUCT AND MANAGEMENT OF THE HOMEXPERSONAL AND HEALTHCARE SUPPORTStandard No 18 19 20 21ClosereachScoreX 3 X XStandard No 37 38 39 40 41 42 43ScoreX X 4 X 1 X XDS0000003532.V262461.R01.S.docVersion 5.0Page 19 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 YA41 Regulation 17 (2) Requirement `The registered person shall maintain in the care home the records specified in Schedule 4 item 7 requires there to be a duty rota of the persons working within the home and the on call arrangements. Timescale for action 31/03/06RECOMMENDATIONS 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 YA24 Good Practice Recommendations The communal areas within the home should be given a thorough clean. The tap on the sink in the ground floor toilet should be tightened so that it can be used properly.ClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 20 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 CSCIClosereachDS0000003532.V262461.R01.S.docVersion 5.0Page 21 - 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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