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Inspection on 11/07/05 for Dalewood Respite Care

Also see our care home review for Dalewood Respite Care for more information

This inspection was carried out on 11th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Care plans are well thought out and the home is working hard to approach them in a person centred way. Staff know service users very well and have a good understanding of their needs and the aims of the home. The environment is comfortable, clean and homely. The garden is well maintained and accessible to service users.

What has improved since the last inspection?

Two new members of staff have been employed and two staff who were acting up into senior positions have been offered permanent positions. The home has also employed someone to provide administration support for two days a week. After recent interviews the home will soon be fully staffed. Five staff have received Person Centred Planning (PCP) training and a two day in-house training event took place which included Adult Protection training which was required at the last inspection. The home now records residents meetings in pictorial format as well as in writing.

What the care home could do better:

Outstanding requirements, as listed at the back of the report, need to be met. The home would benefit from more consistency in providing regular supervision to all staff.

CARE HOME ADULTS 18-65 Dalewood Respite Care 1 Dalewood off Chiltern Way Buckskin Basingstoke RG22 5EG Lead Inspector Liz Palmer Unnannounced 11.07.05 10:00 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. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Dalewood Respite Care Address 1 Dalewood off Chiltern Way Buckskin Basingstoke Hampshire RG22 5EG 01256 332215 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) Hampshire County Council Mrs Laraine Susan Beech Care Home 5 Category(ies) of Learning Disability - LD - 5 registration, with number of places Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3.12.04 Brief Description of the Service: Dalewood is a care home providing respite care for up five adults with a learning disability. It is situated in a cul-de-sac in Kempshott, Basingstoke.The aim of the service is to provide a flexible, accessible, positive, enjoyable and individualised short-term break for service users. Dalewood can accomodate up to two service users on the ground floor who have physical needs and use a wheelchair. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection for the year 2005/2006 and was unannounced. It was completed in three hours. There were no service users at the home during the inspection. The focus of the inspection was looking at the progress being made on the outstanding requirements from previous inspections. Two staff were spoken to and the manager and a senior member of staff assisted with the inspection. Care plans and other documents were looked at. A preinspection questionnaire had been returned as had three relatives’ comment cards and one service user comment card. Two of the relatives were very positive about the care in the home as was the service user. One relative commented on a lack of activities at weekends, this was not assessed on this occasion although it was discussed with the home’s manager. This will be assessed at the next inspection when hopefully service users will be available to comment. All of the outstanding requirements have been addressed but not all have been fully met. No new requirements were made. What the service does well: What has improved since the last inspection? Two new members of staff have been employed and two staff who were acting up into senior positions have been offered permanent positions. The home has also employed someone to provide administration support for two days a week. After recent interviews the home will soon be fully staffed. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 6 Five staff have received Person Centred Planning (PCP) training and a two day in-house training event took place which included Adult Protection training which was required at the last inspection. The home now records residents meetings in pictorial format as well as in writing. 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. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 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 standard(s) 2 Arrangements for assessing prospective service users ensures their individual needs can be met in the home. EVIDENCE: Pre-admission assessments were seen to provide the relevant information needed, for example, physical and emotional care needs, the reason for the respite and any regular educational, recreational or employment activities of the person. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 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 standard(s) 6 and 9 Arrangements for care planning and risk assessing ensure that service users assessed and changing needs are met and they are enabled to take reasonable risks. EVIDENCE: Four care plans were seen to contain the relevant information, such as, personal care needed, preferences for social activities and important relationships. Care plans have all been reviewed since the last inspection and were dated, as required. The home is in the process of re-assessing each service user and updating their files. Risk assessments seen were basic but adequate. Risk assessments covered activities such as cooking and road crossing. The home is planning to devise a new format for recording risk assessments, this will improve the existing system by providing more detail. This will be monitored at the next inspection. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 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 standard(s) None of these standards were assessed. EVIDENCE: Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 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 standard(s) 20 Meeting the outstanding requirements for suitable staff training and reviewing and implementing a new medication policy would provide staff with the knowledge and skills to deal with the home’s medication in a way that protects them and the service users. EVIDENCE: The requirement has not been met for all staff to receive training in the administration of medications which includes, a basic knowledge of how medicines are used, how to recognise and deal with problems in use, and the principles behind all aspects of the home’s policy on handling medicines and records. New staff receive in-house training as part of their induction. A further requirement has been made. The requirement for the home to complete a new Medication policy is still outstanding. This is being addressed at County level. A further requirement has been made. The inspector checked the procedure for administering medication and found the storage and recording to be satisfactory. Stocks are checked and signed for twice a day and stocks matched the records at the time of the inspection. Care plans reflect any individual arrangements, for example, one of the current Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 12 service users has to have his tablets crushed, the reasons are recorded and the member of staff on duty was aware of how this should be done. One dose of medication which had been given had not been signed for. This was discussed with the manager. All other records were accurate. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 13 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) 23 Arrangements for the training of staff in Adult Protection protects service users. EVIDENCE: The home has met the requirement for staff to receive training in Adult Protection. The manager arranged for a whole team training event. One member of staff was on holiday when it took place so is still due to receive the training. Suitable arrangements are in place for the recording and storage of service users monies, for example, money is stored individually and balances are checked and handed over to each shift. Three balances were checked and matched the recorded amounts. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 14 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 and 30 The arrangements for cleaning and maintaining the home ensure that service users stay in a safe, clean and pleasant environment. EVIDENCE: There is a daily cleaning schedule for the home and all areas seen during the inspection appeared to be very clean and hygienic. Staff receive suitable training, such as Infection Control and Basic Food Hygiene. The laundry area was clean and suitable for it’s purpose. Aprons and gloves are provided for staff as are suitable hand washing facilities. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 15 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) 34, 35 and 36 The procedures for recruiting staff protects service users. Arrangements for induction and training enables staff to meet the needs of those who use the service. Staff and service users would benefit from all staff receiving the training required at previous inspections, such as medication training. EVIDENCE: The procedure for recruiting staff includes, suitable application forms, formal interviews, two references and relevant police checks. It was required at the last inspection that these and other relevant documents and information, such as, proof of identity were available for inspection. In respect of the two most recent staff to be employed only one written reference was available on their file. Training records were available and showed that staff have received training in First Aid, Emergency Aid, Approach Training, Autism, and National Vocational Qualifications (NVQ). Two staff have reached NVQ level 2, and one is undertaking it. One is undertaking NVQ level 3 and the manager is doing level 4. Refresher courses for mandatory training, such as, First Aid and Moving and Handling are planned for. Training required at inspection must be provided to all staff. (See standard 20) Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 16 There was a requirement made at the last inspection for all staff to receive regular support and supervision. Records showed that this was happening for some staff and through discussion it was evident that the manager has made an effort to meet this requirement. For example, arrangements were made for one of her senior members of staff to receive suitable training and take on the supervision of some staff. A second senior member of staff, recently appointed to a permanent post will also undertake the training and take on the supervision of some staff. This will hopefully ensure that the regular supervision of all staff will take place consistently. Staff spoken to said they felt well supported and would always discuss any matters with the manager as they arose. Regular staff meetings take place as do meetings of senior staff. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 17 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) 39 and 42 The service user questionnaire devised by the home will enable them to collect service user views and develop the service accordingly. The home has arrangements in place to promote and protect service users’ health, safety and welfare. EVIDENCE: The home has produced and sent out a questionnaire to service users to gain their views on the service. This was as a result of a requirement made at the last inspection. So far, none have been returned. Other ways of approaching this are being looked into by the home. Regular, weekly service user meetings take place and minutes showed that service users were able to air their views about a variety of issues, for example, activities in the home and requests to be involved in food preparation. Staff stated these issues are brought to staff meetings and action is taken. One staff member commented that by introducing pictures as a way of expressing and recording views, meetings are now longer, better attended by service users and more productive. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 18 Moving and handling training is provided to staff, as is Fire Safety. Fire safety equipment is situated around the home as are fire safety notices including the procedure to be followed in the event of a fire. First aid boxes are provided and a member of staff stated she had checked them recently and this is done regularly. Hazardous substances are stored in lockable cupboard. Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 19 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dalewood Respite Care Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 20 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 YA20 Regulation 13 Requirement Timescale for action 1/9/05 2. YA20 13 3. YA34 19 4. YA36 18 The registered person must ensure that training for care staff in the administration of medications is accredited and includes a basic knowledge of how medicines are used. How to recognise and deal with problems in use. The principles behind all aspects of the home’s policy on handling medicines and records. REQUIREMENTS AGAINST THIS STANDARD HAVE BEEN MADE AT THE LAST THREE INSPECTIONS The home must complete the 1/9/05 process of reviewing the Medication Policy and implement the updated version. Information and documents in 1/9/05 respect of persons managing or working in the care home must be available for inspection at all times. REQUIREMENTS AGAINST THIS STANDARD HAVE BEEN MADE AT THE LAST FOUR INSPECTIONS All staff must receive regular 1/9/05 support and supervision. REQUIREMENTS AGAINST THIS STANDARD WERE MADE AT THE LAST INSPECTION H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Dalewood Respite Care Page 21 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 Good Practice Recommendations Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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 Dalewood Respite Care H54 S37131 Dalewood Respite Care 110705 V237917.doc Version 1.40 Page 23 - 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. 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