Inspection on 09/02/06 for Dairy Close

This inspection was carried out on 9th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Dairy Close 02/06/08

Dairy Close 19/10/06

Dairy Close 05/04/05

Dairy Close 29/11/04

Dairy Close 08/07/04

Dairy Close 15/03/04

Dairy Close 07/10/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Dairy Close 20 Dairy Close Leek Staffordshire ST13 6LT Lead Inspector Keith Jones Unannounced Inspection 9th February 2006 2:00 Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Dairy Close Address 20 Dairy Close Leek Staffordshire ST13 6LT O1538 386762 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) Choices Housing Association Limited Maxine Millward Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th April 2005 Brief Description of the Service: Dairy Close is situated in a residential area of Leek. It is registered with the National Care Standards Commission as a care home for four younger adults with a learning disability. The Beth Johnson Housing Association own the property and are responsible for all building maintenance. Choices Housing Association are the care provider. At present there are four men permanently living at Dairy Close. The property is a bungalow situated in a cul-de-sac with good access to the front and rear of the building. It is of a domestic design presenting the same as the other properties around it, and therefore not standing out as a care setting. The home is within walking distance of the town centre and public transport is accessible, although in addition the home has access to a shared car for private transport. The gardens are spacious, secure and well maintained; there is a patio area with seating, tables, a barbeque and greenhouse. The inside of the property is very well maintained, homely and domestic in character. All four single bedrooms are large, airy, personalised and attractively decorated. Bathrooms and toilets are appropriately located throughout the establishment. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was conducted with the care manager and the full cooperation and contribution of care staff and service users present. There were no outstanding requirements or recommendations. A tour of the home allowed free access to all areas of the Home, and open discussion with those service users present and staff. There were four service users in residence, with one feeling unwell and retired to his bedroom. The other three residents were engaged in general conversation, openly declaring that they were very happy with their Home. Resident’s bedrooms were highly personalised and reflected the personality of the individual occupying the room. There followed a sample review of administrative procedures, practices and records. Two service users were randomly selected for case tracking to inspect all aspect of their care at Dairy Close, from referral to the present time. There followed a report feedback in which the inspector offered an evaluation of the inspection. Throughout the entire inspection a sense of homeliness and familiar confidence pervaded into all aspects of daily activity expressed by those people met. The inspector thanked all concerned for their contribution to a pleasing and constructive inspection. What the service does well: Dairy Close offers a high standard of care and service, was observed to be extremely well organised, with a committed care manager and team. Emphasis goes into involving the residents and their families in the process of care, ensuring a highly personal approach to meeting individual needs. The three gentlemen spoken with confirmed their pleasure in their daily routine and involvement. Assessment procedures and care planning is of an excellent standard, offering detailed information on each resident’s progress in the meeting of objectives. The staff and residents all contribute to the team approach. Maintenance of good staffing levels, staff training and supervision are well established in safeguarding the interests of residents. Full attention is paid to the health needs of the service users. Each has a full health audit every six months when the staff talk to them about their physical and mental health and Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 6 their well being is assessed, with referrals to other health services where required. Overall the attitude in meeting caring and organisational demands is highly commendable, with a highly personable involvement and application, contributing to an excellent service. 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. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4 The home had in place a Statement of Purpose and Service Users Guide that provide information to prospective residents and their relatives about the services the home is able to offer this had recently been updated. There have been no recent admissions to determine the effectiveness of admission policy, but the staff maintained that pre- admission assessment is conducted by the senior care manager at the point of referral, with a full multidisciplinary and a community assessment. The most recent admission has settled in very well, although asleep at the time of inspection. EVIDENCE: During the course of the inspection there was ample opportunity to sit and talk with residents and staff. It was evident that much care had been taken in involving residents and family in the caring process. A resident expressed his pleasure at the easiness of the daily routine, and the general friendliness around. The revised Statement of Purpose was discussed and found to provide an informative description of Dairy Close’s aims and the way it operated. Examination of resident’s care records and plans clearly demonstrated the extensive efforts to see through the admission procedure and assessment, Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 9 notwithstanding the difficult referral and admission. Each record showed the attention to individuality and their unique needs. Evidence was seen of that assessment process being applied following admission and in continuing care. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10 Residents spoken to were keen to show the extent of independence and the degree of involvement in their care, a person centred planning approach of care. This focused on positive behaviour, ability and willingness of the individual, showing that service users freely make decisions about their life in the home. EVIDENCE: Care plans were examined and found to offer an excellent record of daily living, which were comprehensive, and included a provider assessment; a person centred plan, a health and safety assessment, and a planned intervention, rehabilitation and therapeutic programme. Evidence of health care professional visits showed an attentive awareness to service user’s needs. It was noted that each day had a different schedule of events encouraging therapeutic and social activities geared to meeting service users sense of belonging. Including risk assessment every day activities. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 11 Two residents were case tracked with a full examination of care records, health records including general practitioners and consultant visits, risk assessments, dependency charts, records of reviews and action plans. Records inspected showed that residents freely make decisions about their life in the home. Residents were seen to be involved in day centre attendances, college, family visits and visits to local amenities. Risk assessments were carried out on an individual basis and reviewed. Included in the care records were applications of established monitoring systems following a process of goals, care and evaluation models. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Throughout the inspection residents were seen to be enjoying a high degree of encouragement to express themselves in positive and meaningful ways. Bedrooms were seen to demonstrate that individuality, each different to match personal outcomes. A fully flexible open visiting policy was identified, reflecting the importance placed upon family or friends’ regular contact. Resident’s links with the community are good. The residents and staff are engaged in setting, planning and preparing varied menus. EVIDENCE: The staff reflected upon the policy indicating a flexible routine, established to meet the preferences of service users. The policy was evidenced in admission assessment, care plans examined, and talking to service users, a policy much appreciated and freely expressed. Routine is seen as flexible to acknowledge Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 13 individuality, yet maintain a focal point for service users to latch on to without dictating events. Staff were observed to hold a friendly, sympathetic and confident interaction with service users in lounge areas in helping those who required assistance. Service users’ life-styles and interests are recorded in their care plans, discussed with their relatives prior to admission, and documented as far as possible to enhance a position of supported independence. The recording of social activities was seen to be a valuable part of care reporting and planning. The management demonstrated the strength of protecting service user’s rights, which was secured through the robustness of the procedures in place. This was confirmed on examination of records. The tour of the Home demonstrated a high degree of expressed individuality in each of the bedrooms inspected with the residents willingness and some pride in presenting their domain. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 21 The Home operates an environment conducive in support of individual physical and emotional needs. The routines involving medication was inclusive whenever possible, yet safe, secure and efficiently administered. Staff had a very good understanding of the residents personal, emotional and physical support needs. EVIDENCE: It was pleasing to see that the administration of medicines adhere to procedures to maximise protection to service users, the storage was secure. A senior member of staff completed MAR sheets accurately, with accountability recorded throughout the process. The philosophy of promoting individuality and self-determination, as laid out in the Statement of Purpose, continues to be seen to be exercised in many aspects of care. The general atmosphere throughout the home was one of family, confidence, warmth and contentment. Staff were observed in addressing service users in a respectful and dignified way. Via the PCP process plans of action to establish the wishes of the service users at death have been Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 15 drawn up, and weekly meetings are held on an individual basis using leaflets and discussion to establish individual preferences. The service user’s spiritual needs are attended to with respect. Relatives are involved and have free access at all times as desired by the service user. At the time of inspection there were no visitors to speak with. It was noted that an appraisal of any special preferences or observances is recorded on admission, and is regarded as integral in the assessment process. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home had a meaningful complaints policy, clearly identifying the CSCI as a resource to approach with a complaint or grievance. Service users’ legal rights are protected by the systems in place in the home to safeguard them, including their contract, the continual assessment of care planning and policies in place. EVIDENCE: The complaints policy was seen and records examined. There were few minor complaints assessed, all dealt with at the source, usually with the resident. On discussions it was evident that any small matters were handled immediately, discretely and to the satisfaction of all concerned. Case tracking confirmed the effectiveness of a care manager and staff sensitive to service users needs and readiness to test the robustness of their information and report structures. Initial problems if integration of the latest admission have been resolved through patience and discrete involvement in Home activities. Residents’ legal rights are protected by the systems in place in the home to safeguard them, including their contract, the continual assessment of care planning and policies in place i.e. the complaints procedure. This process was evidenced on examination, and case tracking as previously reported upon. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 17 Staff induction and in-house training programmes clarified the responsibilities of all staff in their daily contact with service users, especially their privileged position in protecting service users from abuse, of all natures. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 The home is well designed and meets the needs of the service users throughout in a homely, comfortable and safe way. EVIDENCE: The property is less than three years old and is a four bedroom bungalow on a small housing development of similar properties. It is in a quiet road although the town of Leek is close by, as are a range of community facilities. There are large attractive gardens to the front and rear of the property and inside the home is maintained to a high standard, providing spacious and welldecorated accommodation with quality furniture and fittings throughout the communal areas. Each of the service users was proud of their bedroom and showed the inspector around. Each bedroom was well maintained and personalised with TV’s, collections of videos and personal possessions that reflected the interests of the individual. Each service user stated how much they liked their bedroom and the rest of the home. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 19 There is a large bathroom with over bath shower and toilet, and a further bathroom with a walk in shower and toilet. Grab rails had been fitted when the home was first occupied. Evidence was seen that the manager had provided a bath seat for the latest resident. Each of the three other gentlemen is completely mobile. On discussion with the manager it was evident that dirty linen and the disposal of incontinence waste was being dealt with appropriately, so ensuring that service users are not at risk from cross infection. The washing machine has a sluice facility. Disposable gloves and aprons were seen in use. The home was clean and hygienic. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36 Staffing levels were seen to be satisfactory, the daily care staffing rota showed adequate balance between skills, qualifications and numbers to provide a good standard of care. The thoroughness of staff selection has a significant effect upon the provision of cares to ensure protection of service users. Records show a very broad spectrum of clinical and allied subjects covered, ensuring that staff fulfil the aims of the home and meet the changing needs of service users. EVIDENCE: There were four service users receiving care at the time of the inspection. Staffing has stabilised and maintained consistent levels to ensure equilibrium between numbers, skills and qualifications, with a strong presence of experienced staff. Three weeks of off-duty were examined, providing evidence that the home is suitably staffed in numbers, skills and qualifications to ensure the needs of the service users are met. There are two Registered nurses leading a team of eight carers working 224 hours a week. There are two-three staff on duty during the morning and two in the afternoon/evening shift, with one sleep in member of Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 21 staff. The issue of only one staff member being on ‘sleep in’ duty overnight has been raised previously. A staff bank resource meets shortfalls, with rare agency use. All staff receives appropriate induction. Regular supervision take place with staff at the home using the opportunity to address their personal and professional concerns with an immediate senior. All staff receive training specific to their post. At present there are no carers with NVQ qualifications, two staff on training and two being prepared for enrolment. It is a recommendation that this process be firmly established to meet minimum required levels. The Care Manager has completed the Registered Managers Award and already has NVQ Level four. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42 and 43 All staff demonstrated an awareness of their roles and responsibilities, ensuring that the health, safety, and welfare of residents were observed. Policies are meaningful, supported with up to date procedures and skilled application of good practice. Each presents a safe and secure environment in protection of rights, interests, health and safety of the residents. EVIDENCE: The designated care manager has successfully applied a professional, yet personable influence in the running of the Home, demonstrating an enthusiasm measured with practical application. There is a need to formalise the Registration process with completion of the administrative requirements. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 23 There is a confidence apparent in the interaction of staff and the Home’s management that demonstrated a positive relationship, pervading throughout the Home. This open style of management was mentioned by several service users, which provided a source of trust and mutual respect. Quality assurance with the Choices organisation complements this arrangement with extensive monitoring in areas as care planning, staff meetings, staff training and resident’s suggestions. The case tracking undertaken reinforced the effectiveness of resident’s involvement in their care and environment. A sample of administrative, maintenance and care records were examined and found to offer an accurate reflection of a service committed to providing a safe and comfortable environment. Staff training programmes included relevant aspects of Health and Safety, first aid, moving and handling and fire training were recorded. Servicing records of essential equipment were examined and found to be satisfactory. The administration and management of the home was seen to be efficient, uncomplicated and sensitive to the needs of service users. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 3 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 3 26 3 27 3 28 4 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 4 3 3 3 4 3 3 3 3 Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 37.1 Regulation Schedule 2 (7) (a) Requirement That the care manager (designate) complete the Registration administration process Timescale for action 01/04/06 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 32.5 Good Practice Recommendations That NVQ training objectives be secured. Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Dairy Close DS0000041908.V281797.R01.S.doc Version 5.1 Page 27 - 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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