Inspection on 20/06/05 for Danemere

This inspection was carried out on 20th June 2005.

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

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

Other inspections for this house

Danemere 29/10/07

Danemere 23/08/06

Danemere 28/11/05

Danemere 08/02/05

Danemere 29/07/04

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

CARE HOME ADULTS 18-65 Danemere Dane Road Seaford East Sussex BN25 1DU Lead Inspector Kathy Flynn Unannounced 20 June 2005 15.00 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. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Danemere Address Dane Road Seaford East Sussex BN25 1DU 01323 890696 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) Freshford Care Consultants Mrs Tina Williams Care home 1 Category(ies) of Learning Difficulty (LD) 1 registration, with number of places Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1 The maximum number of service users to be accommodated is one (1) 2 The service users accommodated will be adults aged between eighteen (18) and sixty-five (65) years on admission Date of last inspection 8 February 2005 Brief Description of the Service: Danemere is registered to provide residential accomodation and care for one younger adult with an acquired brain injury. The home is a flat on the first and second floor of a semi-detached building. Situated in a residential area of Seaford, within walking distance of the town centre, public transport and the seafront, with GP and dentist surgeries easily accessible. The service users lounge, bedroom, shower room and kitchen/dining room is on the first floor, with staff rooms on the second floor, including a bathroom that the service user has access to. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The previous inspection reports were used to develop the plan for this unannounced inspection. The aims were to assess the homes ability to meet the standards, identify aspects of the service that have been improved and how the service can be developed for the benefit of the service user. The inspection was carried out over two and a half hours from 15.00. It included a tour of the home, an examination of the care plan, risk assessments, records, and training. As part of the inspection process the support and care provided at Danemere were discussed with the staff member on duty and the manager. The service users was happy for the inspection to be carried out, although there were limited opportunities to discuss the support she receives, because at the time of the inspection the service user was spending her time doing housework, going into town and enjoying leisure activities, with the staff. The manager has been in place for over five years and has the experience and skills to ensure that appropriate care is provided. There is a low turnover of staff, which enables the team to provide consistent and skilled care. What the service does well: What has improved since the last inspection? There were no requirements at the last inspection and the manager advised that the staff continue to provide support and care appropriate to the assessed needs of the service user. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 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 Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 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) 3. Standards 2 and 4 are not applicable at this time. The staff have a good understanding of the service users’ support needs. This is evident from the positive relationships, which have been formed between staff and the service user. EVIDENCE: The service provided at Danemere is designed specifically for one service user, therefore no new admissions are being considered. Standards 2 and 4 are not applicable at this time. The home was able to demonstrate that the assessed needs of the service user can be met. The manager and staff were able to demonstrate their knowledge and understanding of the specific needs of the service user. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 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, 7, 8, 9 and 10. There is a clear and consistent care planning system in place to provide staff with the information to meet the service users needs. EVIDENCE: A comprehensive care plan is in place, this includes background information, assessments of the service users needs, risk assessments and guidelines for staff, to ensure that the support provided is appropriate to the needs of the service user. The service user is offered structured choices, within the agreed limitations that have been identified through risk assessments, to enable her make decisions’ about all aspects of her day. The manager and the member of the staff team at the home during the inspection were able to demonstrate an understanding of the homes policy and issues concerning confidentiality. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 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) 12, 13, 14, 15, 16 and 17. Links with the local community are good and support and enrich the service user’s social and educational opportunities. The meals in this home are good offering both choice and variety and catering for the special dietary needs of the service user. A flexible programme of leisure activities enables the service user to develop her interest in art and craftwork. EVIDENCE: The service user has taken part in educational courses in the past. The home is looking at courses available at the local college and hope she may be able to attend one in the new academic year. Staff encourage the service user to try a range of activities including trips out to the local shops, café’s, the nearby attractive park and the seafront. The service user was hoovering the lounge at the start of the inspection and went into the town later in the afternoon, with the carer, to post a birthday card for a relative. She also enjoys a number of leisure activities including knitting and art work, after her trip into town she spent some time sitting in the lounge drawing and colouring. A number of Christmas toys have been made by the service user, Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 Page 11 with the care staff, and there is clear evidence of the artwork that she has done throughout the home. The service user is supported to keep regular contact with family members, this includes texting, phone calls and visits. The service users mother attends meetings and reviews of the services provided. A varied menu offers nutritious meals specific to the assessed needs of the service user. Staff have a good understanding of any limitations concerning food and drink, they are able to offer choices and encourage the service user to take an active role in preparing meals. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 Page 12 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) 18, 19 and 20. The health needs of the service user are well met with evidence of good multi disciplinary working taking place on a regular basis. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure the service users medication needs are met. EVIDENCE: The personal support provided by staff maximises the service user’s privacy, dignity, independence and control over their lives. The manager and staff were observed providing knowledgeable, skilled and sensitive support to the service user. The healthcare needs of the service user are regularly reviewed with the involvement of the family, staff and appropriate health care team, one is planned for a few weeks time, with specialist support provided by hospital consultants and her GP. Medication is secure in a locked cupboard and is dispensed using a monitored dosage system. The medication is regularly reviewed at the hospital and staff were able to explain the effects that such changes may have and how their support changes to meet the assessed needs of the service user. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 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) 22 and 23. Staff have good knowledge of and understanding of Adult Protection issues which protect the service user from abuse. EVIDENCE: A complaints policy is in place at the home, no complaints have been received. Training in Adult Protection is provided for staff who were able to and adult protection policies and procedures are in place. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 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, 25, 26, 27, 28 and 30. The manager has a good understanding of the areas in which the home needs to improve. Planning was in place and set out how this improvement was going to be resourced and managed. EVIDENCE: The service user’s flat is on the first and second floor of a semi-detached building. There is a large lounge at the front on the first floor, a bedroom that the service user has decorated to suit her tastes, with a number of soft toys and ornaments and a shower room. The kitchen is to the rear of the flat and has a dining area with windows that overlook the park and seafront. The dining table is used at mealtimes and for some leisure activities depending on what the service user chooses to do. The staff offices and sleeping in room are on the first floor with a bathroom that the service user has access to. The flat was clean and tidy. Although the carpet on the landing and bathroom should be replaced, it is worn and stained. The furniture in the lounge is large and dated, the manager plans to replace some of it with more contemporary pieces and is obtaining a costing to replace the carpet, which is split in some places. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 Page 15 The environment is homely and comfortable, with specific adaptations to meet the health and safety needs of the service user. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 Page 16 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) 32, 33 and 35. Staff morale is high resulting in an enthusiastic workforce that works positively with the service user to improve their whole quality of life. EVIDENCE: There is a dedicated team of staff working at the home, they have a range of skills, which enable them to meet the service users needs, there are low levels of staff sickness and staff turnover is low. Monthly staff meetings give staff an opportunity to discuss the support and care provided at the home. A training programme is in place, providing mandatory training and specific training to enable staff to provide appropriate support for the service user. The programme is linked to the service users needs and the aims of the home. Recent training has included Working with Individuals with Learning Difficulties and Recognising Abuse. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 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) 37 and 38. The manager has a clear development plan and vision for the home, which she has effectively communicated to the service user, staff and relatives. EVIDENCE: The registered manager has been in post for over 5 years, she will complete the NVQ Level 4 in Care within the next few weeks and plans to do the Registered Managers Award. She is an experienced manager and was able to demonstrate a range of skills, knowledge and expertise, which enables her ensure that the service meets the complex needs of the service user. The process of managing the home is open and encourages the involvement of staff, the service user and the family. Staff feel they can play an active role in the development of the service and feel very supported by colleagues. Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 Danemere x 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x Version 1.20 Page 19 H59 H10 S21352 Danemere V218090 200605 stage4.doc 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 Page 20 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Danemere H59 H10 S21352 Danemere V218090 200605 stage4.doc Version 1.20 Page 21 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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