Inspection on 29/10/07 for Danemere

This inspection was carried out on 29th October 2007.

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 23/08/06

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 Jason Denny Key Unannounced Inspection 29th October 2007 11:30 Danemere DS0000021352.V348716.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.V348716.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.V348716.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.V348716.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 23rd August 2006 Brief Description of the Service: Danemere is registered to provide residential accommodation and care for one younger adult with an acquired brain injury and associated learning disability. The resident’s home consists of a flat on the first and second floor of a semidetached building. The home is 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 user’s 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. The current fees charged for the one resident accommodated is approximately £1800 per week. The latest Inspection report is sent out to any enquirer who expresses an interest in the home. A copy of the report is kept on display in the home with a copy obtainable via the manager. Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced key Inspection, which included a visit to the home which took place between 11.30am and 2.30pm on October 29, 2007. The inspection focused on checking that the good outcomes evidenced in the last inspection report of August 23, 2006 have continued. This visit also included reviewing progress with the minor improvements required in the last report. Care records for the current Resident along with health and medication needs were looked at. Discussions with management looked at future plans and lifestyle opportunities for the current resident. The inspector toured all communal areas of the home with meal arrangements examined. A record of complaints was inspected. Staffing was looked at in detail along with how quality is maintained and improved upon. The inspector met with the current resident, spoke to their family and social services care manager. The visit also included discussion with the manager and all staff on duty along with observation of care-practices and the lifestyle opportunities enjoyed by the resident. The home sent back to the Commission a completed annual quality assurance assessment before the visit which informed inspection planning and this report. Every attempt is made in the Commission’s inspection reports not to identify individuals such as residents, family and social services. This level of privacy is not possible within this report due to the small size of the service, a point, which has been agreed with all people referred to in this report who spoke with the inspector and who agreed to be quoted. All eight-outcome areas are judged to be Good with no urgent improvements required. What the service does well: Danemere is a relaxed, comfortable and friendly environment that offers support and care for one resident who has an acquired brain injury with a range of complex needs. The resident is encouraged to make a full range of choices, with reference to agreed risk assessments, in all aspects of daily life. The resident has a good number of leisure and life skill interests, which the home supports. The resident benefits from a stable and skilled staff team and manager all of whom have worked in the home for a number of years. Staff are very positive about their role and are confident when faced with challenges. Advocates for the resident such as family and social services continue to be pleased with the quality of care and value for money that the service provides. Quotes include “More than happy. I have a good relationship Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 6 with home and all the staff especially the manager who has an excellent relationship with [the resident].. Trust the home implicitly… service works well….. Staff and manager have formed a good and strong relationship with the resident and are very good and knowledgeable” What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Danemere DS0000021352.V348716.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.V348716.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, & 3. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Existing and prospective residents can be very confident that their needs will be carefully assessed and met. EVIDENCE: The homes statement of purpose and Service User guide has been updated into a language more meaningful to the current resident. The manager confirmed that she is in the process of developing the guide further with the use of photographs of staff. The importance of this Statement of Purpose is reduced as the home does not intend to increase numbers with the current resident having lived in the home for many years. The home has developed a more comprehensive Statement of Purpose for staff, Social Services, and families which explains how the service is intended for people with a learning disability and acquired brain injury. The services provided at Danemere are designed for one resident. Therefore no new admissions are being considered. The inspector examined the homes original assessment of the current resident who has lived in the home for a Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 9 number of years. This assessment is very comprehensive and is complemented by a range of information from Social Services. The manager and staff were able to demonstrate their knowledge and understanding of the specific needs of the resident. Observation of the resident and discussions, which also included their relatives and Social Services care manager, indicated that the home continues to meet the resident’s needs. A contract is in place in the form of an individual placement agreement, and involves the resident, relatives, social services and the registered provider. This was examined at the last Inspection. The current fee charged is approximately £1800 per week and includes a minimum of 1:1 staffing at all times. Danemere DS0000021352.V348716.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, & 9. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The Resident clearly benefits from good, skilled and prompt care based on their preferences and abilities. EVIDENCE: To ensure that the needs of the resident can be met a comprehensive care plan has been developed as examined by the inspector. 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 resident. The plan shows evidence of review and input from annual Social Services reviews along with ongoing research by the manager into the residents condition. The plan is good at identifying both the strengths and weaknesses of the resident and clearly states what the resident is capable of doing for themselves such as injections and particular aspects of personal care routines. Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 11 The resident is encouraged to make choices about all aspects of their day, within agreed limitations that have been identified in risk assessments. During the inspection the resident went shopping with two care staff. Risk assessments are thorough and make it clear that only experienced staff persons can take the resident out on their own. The risk assessment contains a range of useful guidelines about how to support challenges. Some overall guidelines particularly those relating to snacks were found to need minor rewording to improve meaning and reflect the positive way the home supports the resident in practice. Both the staff and the manager were able to explain all areas of care planning. Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, & 17. Quality in this outcome area is, Good. This judgement has been made using available evidence including a visit to this service. The resident benefits from being supported to access local community facilities and a range of regular and leisure and other preferred activities based on developing skills and interests. The Resident benefits from freedoms and routines that are flexible and can be confident that they will be treated as a individual. The Resident enjoys food, which is popular, good, and under constant review. EVIDENCE: The resident is supported to make Danemere their home where they are encouraged to take some responsibility for keeping it clean and comfortable. Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 13 The manager again confirmed that the resident 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. Daily records in part written by the resident showed regular outings and other opportunities. The resident enjoys a number of activities including colouring and art, with clear evidence throughout the home of paintings and craftwork. Activities also adapt to changing needs such as college ceasing last year when other issues took precedence. The manager explained how they are researching other more appropriate educational establishments. The manager is currently looking at the provision of a laptop to give the resident the opportunity to develop an interest in alternative leisure activities Contact with relatives and friends is encouraged, the resident is able to spend alternative weekends with her family who play an active role in the multidisciplinary reviews of the care provided. This provides a important advocacy for the resident who without such support could be more vulnerable due to being the only resident in the home. A varied menu offers meals specific to the resident’s assessed needs. The manager, staff and the resident themselves confirmed that they play an active role in choosing and shopping for meals. Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, & 20. Quality in this outcome area is, Good. This judgement has been made using available evidence including a visit to this service. The resident benefits from attentive and skilled health care. EVIDENCE: Personal support is provided in such a way that ensures the residents privacy and dignity, with independence and control fully encouraged. The way in which the home supports a range of complex health needs enables the resident to have good quality of life free from unnecessary restriction. The manager and staff were observed providing knowledgeable, skilled and sensitive support for the resident taking into account their needs at the time. The needs of the resident are regularly reviewed with the involvement of the family, social services, health professionals and the homes management. An annual review is expected to take place in a few weeks time as confirmed by Social Services. Medication is appropriately secured in a locked cupboard and is regularly reviewed during regular hospital visits. The manager was able to demonstrate Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 15 a clear understanding of the potential affects of changes in medication and systems are in place to address any concerns if they arise. Medication administration sheets were all found to be in order with clear guidelines for any emergency medications. It was evident from guidelines and daily routines that there is a focus on successfully supporting health needs in the best interests of the resident who is encouraged to play a full role. Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, & 23. Quality in this outcome area is, Good. This judgement has been made using available evidence including a visit to this service. An effective complaints procedure is in place. The resident feels they can discuss any aspect of their care with the staff, with their opinions listened too and acted upon within recognised and reasonable limitations. EVIDENCE: An appropriate complaints procedure is in place. There continues to be no complaints across successive inspection periods as evidenced in records. The manager and staff along with the resident confirmed that all aspects of their care is discussed with them .The resident is encouraged to question staff about the care provided. The resident also keeps their own daily diary, which describes their day. The resident was relaxed during the inspection and happy to discuss their interests and views with the inspector and staff including their routine for the day. Training in adult protection is provided for all the staff and the manager confirmed that this is regularly repeated. All staff working in the home have had this training on the file including one agency worker who is occasionally used. Relatives and Social Services confirmed that they had no concerns about the service and explained the importance of the manager and the stable staff team in ensuring good outcomes for the resident. Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, & 30. Quality in this outcome area is, Good. This judgement has been made using available evidence including a visit to this service. The Resident benefits from living in a fresh, clean, warm, homely, and comfortable environment, which meets their needs. EVIDENCE: The inspector toured all communal areas. The resident’s flat is on the first and second floor of a semi-detached building, close to Seaford town centre and the seafront. The flat is clean and tidy and improvements continue to be made. The lounge has been fully refurbished which has pleased the resident who was fully involved in all decisions made. The resident benefits from a comfortable and well-equipped bedroom decorated to their taste. The last inspection report indicated a plan for this room to be refurbished. This plan has now been adjusted as the resident is now due to move downstairs which will have the benefits of their being no Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 18 stairs and easy access to a purpose built garden. Similarly, worn carpets reported on last time in the hallway will be attended to after the ground floor area has been adapted for the resident’s intended move. The ground floor area, which is accessed from the street level, requires significant work to be fit for purpose with this planed in 2008. It has not previously been used or assessed for residential care. The home was found to have obtained fire advice following the last inspection visit as required. Auto-closure doors have not yet been fitted on the first floor used by the resident. The service intends doing this on the ground floor when the resident moves. In the interim the manager agreed on the day of the inspection to cease the current practice of leaving open the resident bedroom door at night with a staff memo produced to show the new directive. Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, & 35. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The resident continues to benefit from a well-chosen, skilled and stable staff team. Staff morale is high resulting in an enthusiastic workforce that works positively with the resident to improve their whole quality of life. EVIDENCE: The Inspection visit took place between 11:30 and 2:30pm. The one member of staff increased to two at 12 noon in order to support a shopping trip for the resident. The manager also arrived during the visit, and who also supports on the care side and works shifts. A Clear rota was found to be in operation. There continues to be a low turnover of staff. An agency worker covering the morning shift was found to be highly experienced and explained how she had been given a thorough induction by both the staff and the manager, which included her working shadow shifts alongside experienced staff. Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 20 Sufficient staff have achieved the basic National Vocational Qualification in Care at level 2 or equivalent. The manager continues to organise regular training and team meetings to ensure that the home continue to support the resident according to best practice. The inspector observed good moving and handling techniques being employed by staff. Al necessary staff induction material is in place should any new staff start work in the home. All current staff have had thorough inductions and have full training records as evidenced in one file inspected. All staff have necessary checks carried out as found on the last Inspection. A query from the last inspection about the number of references for staff was found to have been resolved with the resident continuing to be supported by suitable staff. Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, & 42. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from committed and effective management. EVIDENCE: The registered manager has been managing the home for over seven years and has completed NVQ level 4 in Care and the Registered Manager Award. The manager is highly motivated and committed to providing good care to the resident as evidenced in discussions with staff, the resident and their advocates. An inclusive and open management style is maintained with good communication at all levels. Systems are in place to monitor the support and care provided, discussions with the service user occur daily in addition to the ongoing involvement of the Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 22 relatives and social services who contract for this service. The home was found to be working towards a plan for 2008, which includes the resident moving to the ground floor, which is referred to in the homes Annual Quality Assurance Assessment. A written annual development plan was not in evidence with the manager stating that this is being developed with the provider who owns the home. This was not found to be affecting outcomes and given the size and performance of the service a requirement was not made. The manager confirmed that the homes policies and procedures continue to be reviewed and updated so that they are specific to the home. The homes Annual Quality Assurance Assessment confirmed that all health and safety checks continue to be carried out on schedule. The servicing of the gas boiler was in the process of being booked during the day of the Inspection. Relevant Training is provided for staff and includes fire training, supporting people with epilepsy and adult protection. A range of complex health issues requires the resident to have constant supervision. At the last Inspection an issue was discussed whereby staff have to leave the flat to open the front door, usually leaving the resident without available staff. This is now to be resolved when the resident moves downstairs to the ground floor where the front door entrance is located. Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 3 4 X 5 X 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 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard Good Practice Recommendations Danemere DS0000021352.V348716.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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.V348716.R01.S.doc Version 5.2 Page 26 - 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!