Inspection on 04/12/08 for Damascus House

This inspection was carried out on 4th December 2008.

CSCI found this care home to be providing an Good service.

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

Damascus House 16/01/07

Damascus House 29/11/05

Damascus House 16/08/05

Damascus House 04/11/04

Damascus House 01/07/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Damascus House 517 Loughborough Road Birstall Leicester Leicestershire LE4 4BJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Keith Charlton     Date: 0 4 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Damascus House 517 Loughborough Road Birstall Leicester Leicestershire LE4 4BJ 01162671173 01162671173 janekelly73@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Vincent Kelly Name of registered manager (if applicable) Ms Jane Kelly Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: No additional conditions of registration apply. Date of last inspection Brief description of the care home Damascus House provides a service for 12 men and women who have learning disability. The home is located about 4 miles from Leicester city centre close to the village of Birstall. There is a bus stop directly outside the home with a regular service to Leicester City and the village of Birstall is approximately half a mile away and offers a variety of shops and other services. The home is set in large private grounds, which are easily accessible to all residents. There is one large lounge/dining room and kitchen used by six residents and a further lounge, dining room and kitchen used be six residents who need more support with everyday living. There are twelve single bedrooms, (one with en-suite) located over the ground and first floors. Bath and shower facilities are located on both floors. Current fees at the home range from #344 to #363 per week. The last key inspection of the service was on 16/1/07. Care Homes for Adults (18-65 years) Page 4 of 29 care home 12 Over 65 0 12 Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. This was a key inspection that included a visit to the home and inspection planning.Prior to the visit we, the use of we indicates the Commission for Social Care Inspection, spent half a day reviewing information relating to the home. During the course of the inspection, which lasted five hours, we checked thew key standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that we looked at the care provided to three residents living at the home, by meeting them, talking with the staff Care Homes for Adults (18-65 years) Page 6 of 29 who support their care, checking records relating to their health and welfare and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home including health and safety and management issues were examined. We also talked with seven residents, one relative, the Manager and two care workers. What the care home does well: What has improved since the last inspection? What they could do better: Care plans need to include a specific plan of action to deal with challenging behavior, in order to protect residents and staff. Medication must always be hygienically issued to protect residents health. If accidents mean serious injury to residents then medical services must always be called, to fully protect residents health. Staff need to be aware of the full adult protection procedure to protect residents from abuse. Health and safety systems need to be tightened so that all issues are risk assessed and dealt with if they present a danger to residents. Care Homes for Adults (18-65 years) Page 8 of 29 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are assessed prior to admission to ensure the home is suitable for them. Evidence: As people living at the home have been there for a number of years, there have been no new admissions. People who are considering coming to Damascus House would be invited to visit prior to making a decision. The Manager carries out an assessment of their needs and information is sought from health and social care professionals where appropriate. There was evidence on file as to the assessment of residents needs. One resident said, I was made very welcome by everyone when I first came here. This process helps to ensure the home is suitable for those who are considering living there. The homes guide helps people as it contains pictures to help them see what the home would be like to live in it. Care Homes for Adults (18-65 years) Page 11 of 29 Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive good care and they can influence the way the service is run. Evidence: A resident said, I know I have a care plan and I go through it with Jane, my key worker, to make sure it is ok. Care plans are well organised and give clear instructions to staff on how to meet residents needs. They are begun once a resident comes into the home and regularly reviewed and updated. Those we looked at showed that staff make every effort to respect residents wishes. For example one resident said he did not want to go to the day centre so he stayed in the home and did what he wanted to do as he had his hobbies to interest him. Most of the homes residents suffer from autistic spectrum issues which can cause behavioral problems. Staff manage these behaviors by getting to know the residents and finding out the best ways to assist them in the activities of daily living, for Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: example, knowing their characters and routines. There are risk assessments in place to reduce risk to the person and others. However there are no specific details in place for these interventions.This needs to be put right so staff have clear written guidance about how best to address challenging behavior.This will help to ensure that residents are always fully cared for and a consistent approach used. The Manager said she would arrange staff training on this issue to equip staff to meet any challenge. Residents said that there were asked about things that were important to them holidays, trips out, food, their key workers etc. We get asked about things and then Jane tries to arrange it, one resident said. The Residents Meeting notes reflected this and were well set and and detailed if anyone wanted to check what residents views were. We observed that staff were very friendly and respectful to the residents and residents said that the staff were more like their friends and they were encouraged to get on together. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have lots of opportunities to follow vocational, leisure and community activities, are given good support in to maintaining relationships with family and friends and enjoy good, nutritious food. Evidence: Most residents go to day centres for people with learning disabilities on weekdays though older residents attend less frequently. One resident said, I got bored with the centre so I dont go any more and that suits me as I like it better here. This shows that staff respect residents choices. Other people have been involved in college courses and a resident gave a lot of detail as to all the courses that she had attended. Residents are supported to keep in touch with their families and friends. A relative was spoken to as she was picking up her brother to go to see his mother on his weekly visit. The relative had high praise for the way the home was run and the staff. Good Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: use is made of local facilities such as shops and the hairdressers and residents were seen to go out on a shopping trip. A resident said that they were to go to Leicester before Christmas to see the lights. Discussion with residents and staff members indicated that residents are well supported in following their activities. An annual holiday is arranged. One resident said she did not like to go on the holiday and she was able to have day trips instead. Residents said that they also go to the cinema, pubs, and restaurants on a regular basis and they can go to the local church if they choose. Residents continue to be involved in day to day aspects of running the home such as vegetable preparation, setting tables and washing up. A rota is displayed in the home showing who is responsible for chores and residents spoken with knew what they had to do and said they liked doing it. Residents said that the food was good and that they enjoyed it Food records showed that fresh vegetables and fruit were regularly served and the inspector saw that residents had the choice of a wide range of fruit and vegetables for their evening meal. No one objected that there is no dessert for weekday meals. This showed a real emphasis on healthy eating. One resident said, We have a cooked breakfast on Saturdays and we like this. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive appropriate personal support and their health and medication needs are met. Evidence: A resident said, If I dont feel well than I go to see the doctor. Care plans showed that residents receive all healthcare services and that health problems are handled by the GP, District Nurses and other healthcare professionals. Residents are supported to access all healthcare services including opticians, dentists, and chiropodists. Plans clearly outline residents personal care needs and this information was confirmed through discussion with residents and staff. Accident records were seen by the inspector and all incidents handled appropriately except one instance where a resident hurt an ankle and this was dealt with in house. The Manager said that such instances would be reported to medical authorities in the future. The manager also needs to report incidents involving medical treatment, under the Regulation 37 procedure. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Medication is stored appropriately and staff who administer it have received suitable training as supported by training certificates. Records were checked and were up to date. The inspector saw medication being issued to residents which was done appropriately except for when medication was spilled but still supplied to resident, thereby being a possible health and safety risk. The Manager said this was a mistake and it would not be repeated. There was a query regarding whether a medication was given on an as needed basis or not. The Manager said this would be followed up with the pharmacist. Documentation stating under what circumstances certain residents can be given as required medication was seen to be in place. The Manager said she would review this for all residents to ensure staff are always clear on when to supply this medication. Residents medication is reviewed at regular intervals. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to protect residents from abuse. Evidence: Residents said that they thought if they had a problem it would be dealt with by the staff or Manager. One resident said, there is nothing to complain about. We are all happy living here. A complaints procedure is in place with standard forms to complete if there is a complaint. The procedure does not state that the person has a choice to complain to the Lead Agency, the local Social Services Department, or contact details of this Department. The Manager said this would be followed up. The Manager stated that the home has never received any complaints. The Commission has also received no complaints about the service. It was again observed that staff residents and the Manager had an open and friendly manner with each other. Staff have received training relating to the prevention of abuse as part of their National Vocational Qualifications training. Staff members spoken with has a good grasp of how to report such incidents to the Manager and Provider but were unsure as to which outside Agencies to report to if no action was taken. The Manager said this would be followed up with staff. Care Homes for Adults (18-65 years) Page 19 of 29 Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean comfortable and homely environment. Evidence: Residents said that they liked their rooms: Its my room and I can have what I like in there, one resident said. We looked at all communal areas and most residents bedrooms. Residents bedrooms are highly personalised and show evidence of the characters of their occupants. Lounges and dining rooms are well decorated and comfortably furnished. The Manager said that maintenance issues are quickly dealt with. The hot water in one bathroom was checked and found to be within a safe standard. The Manager said that water outlets had valves fitted to them to ensure residents were protected from scalding water. Radiators were not found to be covered. A risk assessment is needed to ensure that they does not pose a burning risk to residents and to provide covers if it poses a risk to residents. All areas of the home were clean and tidy except one bedroom though there was found Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: to be a plan of action to try to tackle this. There was evidence in staff files that staff had received training in infection control. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported and protected by well trained staff and effective recruitment practices. Evidence: Staff and residents said they thought there were enough staff members on duty to meet residents needs. The Manager said that the level of staffing related to the number of residents in the home and whether there were events which needed more staff on duty. So when there were three or less residents there was one staff on duty, mostly there were two staff on and with events on - residents going out etc, there were three staff on. This was supported by the staff rota we saw. Staff said that they were encouraged to do National Vocational Qualifications in care at level 2 and a staff member appointed within the last six months said that she had received a full induction. Staff records proved this. The Manager said that all staff have a training and development record. We saw that this included certificates of courses attended, and supervision and appraisal records. The Manager was recommended to set up a Training Matrix so at a glance it can be seen what staff need training in particular issues. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Staff records were examined and contained evidence that Criminal Records Bureau checks in place before staff members started work, complete employment histories were in place, and two written references had been obtained. This protects residents from unsuitable staff. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good management practices are in place but health and safety systems need further detailed assessment. Evidence: Staff and reidents said that the Manager rang the home very well and supported everyone all the time. One resident said, Jane is really good. She will help you do things you want to do. The Manager has completed her National Vocational Qualification in care at level four as well as the Registered Managers Award. She has sixteen years experience of residential care. Residents views inform how the home is run as Resident Meeting notes record their suggestions. e.g. for activities, meals and decor and are then implemented. Minutes are well written and detailed if anyone needs to refer to them. Residents, relatives and professionals have been surveyed by way of a detailed survey. These surveys were very positive. Relatives said, A home so excellent...it is a Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: wonderful home, All the staff are friendly and polite, I believe Damascus House is a model home, were some of the many positive comments. Systems are in place to ensure residents health and safety, including training for staff in first aid and food hygiene. Certificates were available to demonstrate that this training had taken place. Records show that fire equipment and systems are regularly tested and maintained and that fire drills are held at regular intervals. Gas and electrical systems are also regularly serviced and cleaning materials are stored appropriately. What was not in place were detailed risk assessments regarding safe working practices, e.g. fire risk assessment, control of substances hazardous to health, hotness of radiators, risk of falling in the pond, staff on duty on their own and all other safety features. The Manager said this would be put in place as quickly as possible. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 4 There must be Risk Assessments carried out for all safe working practices. To protect residents and staff from any potentially dangerous situations. 09/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 That care plans provide more specific detail as to how to deal with any challenging behavior identified and that staff receive training to better equip them to deal with these issues. Residents with potentially serious medical conditions always need to be referred to medical services. Medication must only be issued where it is hygenic to do so. Staff need to be aware as to how to follow the full adult protection reporting procedure to fully protect residents welfare. 2 3 4 19 20 23 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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