Inspection on 24/11/06 for Curlews

This inspection was carried out on 24th November 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Curlews 05/01/06

Curlews 20/10/05

Curlews 10/02/05

Curlews 22/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Curlews Dunsland Jacobstowe Okehampton Devon EX20 3RH Lead Inspector Anita Sutcliffe Unannounced Inspection 24 November 2006 10:30 th Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Curlews Address Dunsland Jacobstowe Okehampton Devon EX20 3RH 01837 810856 01837 810819 curlews@atlas.plus.com 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) Atlas Project Team Limited Mr Michael James Brummitt Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users with a Learning Disability (5) Age 18 - 65 years Date of last inspection 5th January 2006 Brief Description of the Service: Curlews is a care home providing personal care and accommodation for five people, aged 18 - 65, with learning disabilities who may demonstrate behaviours that challenge services. It is owned by the Atlas Project Team Limited, which is a private sector organisation, owning several other care homes in Devon, Berkshire and Surrey. This home is located in a rural setting, and there are no close neighbours. The home provides transport for service users to access shops, pubs, and other amenities. The home was opened in 2002 and is comprised of a two-storey detached house. There has been a recent conversion of the integral garage into a bedroom, en suite bathroom and lounge. All the home’s bedrooms are single and three of these have en suite toilet and shower facilities. There are separate lounge and dining rooms, as well as a large sunroom on the ground floor. Part of the lounge room has been designated as a smoking area. The home has a very large garden, with parking facilities and a paddock at the back of the house. All areas are accessible to the service users. Current fees are between £ 2,005 and £ 2,709. Additional charges are made for personal items and some holiday spending money. The most recent inspection report is available at the home on request. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information toward this key inspection has been gathered since April 2006. The home provided current information about its service. Each staff member and health and social care professionals had the opportunity to complete an anonymous survey and comment about the home. The visit to the home was unannounced and four of the five service users were met. The home was toured and four of the five bedrooms visited. Records were examined and staff observed in the course of their work. One staff member was spoken with at length. The manager and a representative from the organisation were present. What the service does well: Staff are kind and caring. They know what they are doing. You can feel safe at Curlews. You can have a good life. It is a very good home. The needs of service users are the priority of the home and organisation. They are very well supported to meet their full potential in a friendly, safe and homely environment. Staff are very enthusiastic and proud of the service they provide, one saying “I love it”. There is clear leadership and good support. Staff are skilled and competent. The home is of modern design, attractive, light, nicely furnished and well maintained. What has improved since the last inspection? There was nothing to improve from the last inspection. The integral garage has been converted into a two-roomed annexe, which provides almost self-contained accommodation of a high standard for one service user, newly admitted to the home. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 4 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Newly admitted service users are fully involved in their admission, given lots of opportunity to find out about the home, the people and what their life would be like there. Their needs are fully assessed and understood before they are admitted. EVIDENCE: There have been two new admissions since the previous inspection of the home, one very recent. Both of those service users were met; one provided a lot of information toward the inspection. In both cases the service user had been fully involved in the decision to be admitted, and the move very well planned. There was excellent support during readjustment and settling in to the home. In one case this had extended over a two to three week period. Staff demonstrated how this would to continue as required. The assessment and support planning records were detailed and informative. Needs are discussed on a daily basis, with full involvement of the service user in decision-making. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 9 Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are listened to, understood, and supported to enjoy a varied and fulfilling life. Risk is understood and well managed. EVIDENCE: On arrival at the home one service user was cleaning, another getting himself a hot drink. They spoke of their plan for that day. Staff understand service user’s needs and adjust routine in their best interest, with their understanding and agreement. They support service users in reducing behaviour that adversely affects their life, enhance positive behaviours that enrich their lives and teach new skills. Care manager’s surveyed were very complimentary about the home’s abilities and standards. Service users are relaxed, confident and comfortable in the presence of staff and management. They are encouraged to be involved in all aspects of their life and supported towards achieving their full potential. Where risk is involved Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 11 this is understood and well managed; there is consultation with other experts as appropriate through ‘best interest’ meetings. Assessment, support planning and events are recorded in detail. This, plus strong teamwork, ensures consistency. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents enjoy a quality lifestyle and are supported to reach their full potential. They receive a nutritious varied diet, which they enjoy. EVIDENCE: During the inspection visit service users were observed very much ‘at home’. One talked about how much happier he is now he’s living at Curlews with friends/residents he gets on well with. Service users are encouraged to develop their skills and knowledge. Two attend college one day a week. One works with a staff member at another home. He described the sense of worth that gave him. Service users receive ‘development incentives’ which might be a wage or additional activity; it would demonstrate a value on what has been achieved. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 13 There is excellent opportunity for hobbies and interests. These currently include photography, golf, darts, swimming, films and music. Individual holidays have included Amsterdam, France and Cornwall. Outings for work and leisure are a normal feature of life at the home. Service users take turns to choose the menu for a week. Two of them described the variety of food saying they were very satisfied with it. The fridges and freezers were full. Fresh fruit was available. The standard of food is good and appropriate to the age and needs of the service users. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal and health care needs are understood and met. Medication is handled diligently, with strict controls in place to ensure service user well being. EVIDENCE: Service users rely on staff to ensure any health care needs are met. Records showed that this is achieved with the involvement of health care professionals as required. Discussion was held as to how service users’ ‘well man’ and ‘well woman’ age appropriate health checks are achieved. Aspects of this will to be discussed with general practitioners. The emotional health care needs of service users are well met. Staff are able to demonstrate a good understanding of how to provide effective and measured emotional support. No current service user has the ability to safely handle their medicines, so this is done for them. Medicines are securely stored. Staff receive training. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 15 Records are clear and orderly and each medicine can be fully accounted for. When a variable or little needed medicine is used this can only be given with permission from a senior member of the organisation. Medicines received from the home’s pharmacy are then dispensed into a monitored dosage box. The inspector is informed this is “so as to reduce the likelihood of mistakes”. However, this practice does not comply with the Royal Pharmaceutical Society guidelines for care homes, which states that ‘Medication should never be secondarily dispensed for someone else to administer to the service user at a later time or date’. This practice should be reconsidered. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that complaints would be taken seriously and dealt with properly. They are protected from abuse through strong leadership and the culture of the home. EVIDENCE: Neither the home, nor the Commission, has received complaints about Curlews. Service users would be unlikely to use a formal complaints procedure but there is a daily house meeting and staff have the skills to communicate well. Problems not communicated would be recognised, dealt with promptly and appropriately. There is strong management within the organisation with a passion for the protection of service users, who were clearly relaxed and confident in the presence of staff. Staff receive training in the protection of vulnerable adults. They are fully aware of their responsibilities and what measures to take should there be concerns. The home has effective policies and procedures in complaints and the prevention of abuse. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a modern, well-equipped and attractive home, which meets their individual needs and preferences. EVIDENCE: Curlews is furnished and equipped to a high standard. Service users said they were very pleased with their accommodation. Bedrooms are decorated and personalised to service user choice. Being of a modern design the home seems particularly suited to the age group of current service users. Facilities are excellent. The home was clean, fresh and light. The newly completed two-roomed annexe was inspected for the first time and seemed very satisfactory. The grounds are large and well kept. A service user talked of his time and activities when out there. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 18 The laundry facility is adequate to meet the needs of current service users and their laundry is done separately. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from staff that are skilled, experienced and well supervised. They are protected through robust recruitment practice. EVIDENCE: Service users were not asked to comment on the staff but were clearly relaxed and confident in their presence. Staff were unable to think of anything the home doesn’t do well. They are enthusiastic about the work they do. They demonstrate knowledge, skills and competence. There is a good understanding of the boundaries between friendship and support for service users. They feel very supported and well supervised by the manager and organisation and are in no doubt as to what is expected of them. The home’s recruitment policy is strictly followed. Staff do not work unsupervised until it is assured they are safe to work with vulnerable adults, and have sufficient skills to work safely and effectively. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 20 Staff training provides the knowledge from which to deliver a high standard of support and care to service users, and it helps keep staff safe. It includes first aid, health and safety, behaviour management and prevention of abuse. A high proportion of staff have achieved the National Vocational Qualification (NVQ) in care, an indicator of competence. A staff member said he was keen to further increase his knowledge through training. Staff are provided in good numbers. There is a rotational scheme in place to ensure that night staff are also able to work with service users in the day, therefore maintaining familiarity with their needs. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed, run in the bet interest of residents, and their health and safety are properly attended to. Providing quality care is the focus of the organisation. EVIDENCE: Service users appear comfortable, happy and fulfilled and say they like it at Curlews. Their views are listened to and taken into account. A member of staff said: “We have a really strong team here. Everybody works together”. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 22 There is an effective management structure within the organisation and home. There is very strong leadership and support for staff. Staff are clear what is expected of them and receive a good standard of training. The home is well run. The health, safety and welfare of service users are well managed and residents have involvement in this. When a service user was asked about fire safety he was very clear as to what he should do if the fire alarms sounded. There are daily planning meetings for service users and staff. The standard of maintenance is good. Effective care planning and support also decrease risk and promote welfare. Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 3 4 4 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 X 29 X 30 3 STAFFING Standard No Score 31 4 32 4 33 4 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 4 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 4 3 3 X 3 X Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 24 Not applicable Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Curlews DS0000032251.V309408.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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