CARE HOME ADULTS 18-65
Dalecroft 94A Keighley Road Illingworth Halifax HX2 8DN Lead Inspector
Cheryl Stovin Unannounced Inspection 21st February 2006 13:00 Dalecroft DS0000051646.V285371.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 Dalecroft DS0000051646.V285371.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. Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Dalecroft Address 94A Keighley Road Illingworth Halifax HX2 8DN 01422 246646 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) Holly Bank Trust Miss Sarah O`Sullivan Care Home 6 Category(ies) of Physical disability (6) registration, with number of places Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Care for up to six adults with a physical disability who may also have a learning disability or sensory impairment. 30th August 2005 Date of last inspection Brief Description of the Service: Dale Croft is owned and managed by the Holly Bank Trust and is registered to provide accommodation and care for for six young adults who have physical and learning disabilities. The accommodation comprises of an adapted bungalow and an adjacent self contained flat, which provides accommodation for a service user which promotes indepenance. Service users are included in decisions about their lives, through person centred approaches in the home. Dale Croft is located in the Illingworth area of Halifax and is within close proximity of the main Keighley Road and public transport links. The home is a detached property, designed over a single floor. Adaptations have been undertaken to promote wheelchair access and meet the mobility and personal care needs of service users. The accommodation offers spacious communal areas and a private, landscaped and accessible garden, where service users are able to spend time in the warmer weather. Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 21st February 2006. Over an inspection year from April until March, care homes have a minimum of two inspections a year. The last inspection was also unannounced and took place on 30th August 2005. What the service does well: What has improved since the last inspection? What they could do better:
All of the residents of Dalecroft have detailed and holistic individual support specifications to which the service users fully participate in drawing up. It was noted, however, that the care plans are not dated and signed by the member of staff producing the document. There is a commitment to training within the home, however, only one member of staff has completed their NVQ II award, and Standard 32 of the Care Homes for Younger Adults states that 50 of care staff to be qualified to NVQ II or equivalent by 2005. Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 6 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. Dalecroft DS0000051646.V285371.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 Dalecroft DS0000051646.V285371.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 Service users needs are fully assessed prior to admission. EVIDENCE: Records seen provided evidence of assessment prior to admission. Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 9 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 Service users needs are thoroughly assessed and the home has a good approach to promoting the service users health care. EVIDENCE: Each service user has an individual personal support plan, which is detailed and holistic and covers activities of daily living as well as social and emotional needs. Each service user signs to say they are in agreement with the content of the care plan, and the aims and objectives set at each review. It was noted, however, that the care plans were not dated nor signed by the member of staff drawing up the document. All service users are routinely assessed by a Physiotherapist and an Occupational Therapist and have detailed manual handling plans. Risk assessments are in place, however, the documents were stated to be due for reassessment in November 2005, but there was no evidence of this being carried out. Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 10 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): 12,13,14,17 Service users are encouraged to exercise choice and care is provided in a flexible manner to enable residents to follow their preferred lifestyle. EVIDENCE: Service users are encouraged and enabled to participate in a wide range of community social and recreational activities. Recent activities have included going swimming, visiting the pub, pictures, bowling and theatre trips. One service user is currently enjoying attending a hair dressing course. . Holidays are enjoyed by the service users, this years destinations are being currently planned. Each service user has a day when they choose what the main meal of the day will be, and help prepare the meal, during the inspection a service user and a member of staff were preparing cottage pie. Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 11 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): 20 The systems for handling and administering medication within the home are robust and safe. EVIDENCE: The establishment uses the Boots MDS (Monitored Dose System) for the administration of medication. The stocks of medication are securely and appropriately stored and records seen reconciled with stocks held. One service user controls and administers her own medication. Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 12 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): None of these standards were inspected on this occasion. EVIDENCE: Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 13 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): None of these standards were assessed on this occasion. EVIDENCE: Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 14 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): 31,32,35 EVIDENCE: From records examined and following observation and discussion during the inspection, sufficient staff are employed to meet the needs of the service users. The staff team were observed to be meeting the needs of the service users in a sensitive and dignified manner, with appropriate use of informality and humour. There is a commitment to staff training within the home with an on-going programme of NVQ training, however, only one member of staff currently holds their award. All new staff receive appropriate induction training. A wide range of training courses are available, which are displayed in the staff room Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 15 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): None of these standards were assessed on this occasion. EVIDENCE: Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 16 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 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 3 32 2 33 x 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x x x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 x 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x x x x x x 3 x Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 17 no 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 YA32 Regulation 19 Requirement 50 of care staff to be qualified to NVQ II. Timescale for action 31/08/06 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 YA6 Good Practice Recommendations Care plans to be dated and signed. Dalecroft DS0000051646.V285371.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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