Inspection on 23/08/06 for Danemere

This inspection was carried out on 23rd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

Other inspections for this house

Danemere 29/10/07

Danemere 28/11/05

Danemere 20/06/05

Danemere 08/02/05

Danemere 29/07/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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 Key Unannounced Inspection 23rd August 2006 13:00 Danemere DS0000021352.V299501.R01.S.doc Version 5.2 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 Danemere DS0000021352.V299501.R01.S.doc Version 5.2 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. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Danemere Address Dane Road Seaford East Sussex BN25 1DU 01323 890696 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) Freshford Care Consultants Mrs Tina Williams Care Home 1 Category(ies) of Learning disability (1) registration, with number of places Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is one (1) Service users must be aged between eighteen (18) and sixty-five (65) years on admission Service users with a learning disability only to be accommodated Date of last inspection 28th November 2005 Brief Description of the Service: Danemere is registered to provide residential accommodation 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 DS0000021352.V299501.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out on the 23rd and 31st August and took place over 6 hours. The inspection included a tour of the home, a review of care plan, risk assessments, staff records, policies and procedures. The service user was not at the home on the first day of the inspection, but was aware of the second days inspection and was happy to discuss the support and care she receives. A pre-inspection questionnaire and service users survey were sent to the home, these were completed and returned. What the service does well: What has improved since the last inspection? Improvements have been made to the homes environment, a new carpet has been fitted in the lounge and it has been redecorated, with pictures painted by the service user decorating the walls. The room now looks more contemporary and the service user is very pleased with the results. The manager explained that they are looking for alternative educational opportunities for the service user, in particular the provision of a laptop computer. Regular feedback is obtained regarding the service from the multidisciplinary team involved in the service provision, the service user and relatives. This is to be included in a quality assurance monitoring system to be developed that is particular to this home. Policies and procedures have been reviewed and updated. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 6 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. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 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 Danemere DS0000021352.V299501.R01.S.doc Version 5.2 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): 1,3 and 5. Standards 2 and 4 are not applicable. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The homes statement of purpose and service users guide does not include sufficient information regarding the services provided and how they meet the service users needs. The staff have a good understanding of the service users support needs. This is evident from the positive relationships, which have been formed between the staff and service user. EVIDENCE: The services provided at Danemere are designed for one service user. Therefore no new admissions are being considered, standards 2 and 4 are not applicable at this time. The statement of purpose and service users guide has been reviewed. However it continues to provide basic information about the services provided by Freshford Home Care Consultants. It does not provide information specific to the services offered at the home. It requires further review and updating to ensure that if reflects the support and care offered to the service user. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 9 The manager was able to demonstrate her knowledge and understanding of the specific needs of the service user, and confirmed that staff work as a team and are able to provide the support and care the service users needs. A contract is in place in the form of an individual placement agreement, and involves the service user, relatives, social services and the registered provider. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. There is a clear and consistent care planning system in place to provide staff with the information they need to meet the service users needs. EVIDENCE: To ensure that the needs of the service user can be met a comprehensive care plan has been developed. This includes an ongoing assessment of needs, risk assessments and guidelines for staff to follow, which enables the staff to provide the support and care needed by the service user. The service user is encouraged to make choices about all aspects of her day, within agreed limitations that have been identified using risk assessments. On the first day of the inspection the service users was shopping with care staff in Eastbourne, and they were expecting to have lunch there. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 11 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): 12,13,15,16 and 17 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Links with the local community are good and support and enrich the service users social opportunities. A flexible programme of leisure activities enables the service user to develop her in art and craft work. EVIDENCE: Danemere is the service users home and she is encouraged to take some responsibility for keeping it clean and comfortable, and is able to make decisions about improvements to the environment. The manager confirmed that she takes part in a number of activities outside the home including trips to local shops, cafés and the park. The seafront is close by and walks along the seafront are a regular occurrence when weather permits. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 12 The service user enjoys a number of leisure activities including colouring and art, with clear evidence throughout the home of her paintings and craftwork. Contact with relatives and friends is encouraged, the service user is able to spend alternative weekends with her family and her mother plays an active role in the multi-disciplinary reviews of the care provided. The manager is currently looking at the provision of a laptop to give the service user the opportunity to develop an interest in alternative leisure activities. A varied menu offers meals specific to her assessed needs. The manager confirmed that the service user plays an active role in preparing meals, and staff have a good understanding of any limitations regarding food and drink, with appropriate choices offered. A food awareness course provided by the Food Standards Agency is to be introduced for all staff to follow, in addition to the Food Hygiene Course that they are required to complete. It will be included as part of staff training and includes information on cleaning, chilling food and cross contamination. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 13 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): 18,19 and 20 Quality in this outcome is good. This judgement had been made using available evidence including a visit to this service. The health needs of the service users 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: Personal support is provided in such a way that is ensures the service users privacy and dignity, with independence and control over her life encouraged. The manager was observed providing knowledgeable, skilled and sensitive support for the service user, taking in to account her needs at the time during the second day of inspection. The needs of the service user are regularly reviewed with the involvement of the family, social services, the health professional and the homes management. A review is expected to take place in a few weeks time. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 14 Medication is secure in a locked cupboard and is regularly reviewed by during hospital visits. The manager was able to demonstrate a clear understanding of the potential affects of changes in medication and systems are in place to address any concerns if they arise. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. A complaints procedure is in place, the service user feels she can discuss any aspect of her care with the staff, she feels that they listen to her opinions and act upon them, within recognised limitations. EVIDENCE: An appropriate complaints procedure is in place, there have been no complaints since the last inspection. The manager confirmed that all aspects of the service users day is discussed with her, her opinions are sought on every aspect of the services provided and she is encouraged to question staff about the care provided. The service user was relaxed during the inspection and happy to discuss her interests and how she spends her time. Her comments about the care staff were very positive, she felt that she is able to make choices, the staff listen to her and support her in what she wants to do, and she did not raise any concerns. Training in adult protection is provided for all the staff and the manager confirmed that this is regularly repeated. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome is good. This judgement has been made using available evidence including a visit to the service. The standard of décor within this home if adequate and there is evidence that improvements have been made to make the home comfortable and homely. EVIDENCE: The service user’s flat is on the first and second floor of a semi-detached building, close to Seaford town centre and the seafront. The flat was clean and tidy and some improvements have been made. The lounge carpet has been replaced, the service user chose the colour and is pleased with the changes made to the room. The manager has identified that the carpet in the bedroom needs to be replaced and this will be done later in the year, the service user has already decided on the colour. The carpet in the hallway has not been replaced and is old and worn and is part of the manager’s improvement plan for the home. Maintenance of the flat Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 17 is ongoing with the manager making a list of repairs or replacement, which is checked by the maintenance person on a regular basis. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 18 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): 32,34 and 35 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Staff moral 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, the manager and four care staff work together to provide 24 hour support and care. There are low levels of sickness and staff turnover also low. The manager and staff are able to discuss the service users needs during hand over at the beginning of each shift, and during the monthly staff meetings. Supervision is provided and linked to the training programme that staff are expected to follow. Induction training is provided for all new staff and continues until the manager feels that the member of staff is able to demonstrate appropriate support for the service user. The recruitment procedures have improved and the manager advised that she does not employ any staff until POVA/CRB checks are completed, irrespective of whether they have worked at the nursing home and domiciliary care agency owned by the same provider. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 19 However it was noted that one member of staff only had one reference although the individual is know to the provider, and she stated that this would be rectified. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The management of the home is appropriate to meet the assessed needs of the service user. EVIDENCE: The registered manager has been managing the home for over six years and has completed NVQ level in Care and the Registered Manager Award, there are clear lines of accountability at the home. Her management style is open and encourages the involvement of the service user, relatives and staff in developing the services provided at the home. Systems are in place to monitor the support and care provided, discussions with the service user occur daily in additions to the ongoing involvement of the relatives and social services who contract for this service. However there is Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 21 not annual development plan in place and the manager explained that this would be developed by the registered provider. The manager confirmed that the homes policies and procedures have been reviewed and updated so that they are specific to the home. Training is provided for staff and includes fire training, supporting people with epilepsy and adult protection. The manager discussed the importance of ensuring that staff can enter the service users bedroom to ensure the safety of the service user. A recent incident highlighted the importance of this and she will be obtaining advice from the fire service regarding the most effective way of accessing the bedroom while protecting the service users privacy. Currently the door is held open with using ‘cat’ guard, the manager is aware this is not appropriate but explained that it is a short term measure. The manager discussed the appropriateness of staff leaving the flat to open the front door, particularly as there is often one member of staff working at the home most of the time. An alternative system, which would enable staff to remain in the flat with the service user at all times should be may be more appropriate. She advised that she would look into this. Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 22 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 2 2 X 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 X Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA1 Regulation 4&5 Requirement The statement of purpose and service users guide to be reviewed and updated to reflect the services provided by the home. The home to review, update and follow appropriate recruitment procedures. A quality assurance and monitoring system of the services provided to be developed and introduced. Appropriate advice to be sought from the fire service regarding keeping service users door open. Timescale for action 02/10/06 2. 3. YA34 YA39 19 (4)(b)(i) 24 02/10/06 06/11/06 4. YA42 24 02/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Sussex Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Danemere DS0000021352.V299501.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!