Inspection on 18/07/05 for Davie House

This inspection was carried out on 18th July 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

Davie House 14/11/06

Davie House 31/12/05

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Davie House 33 & 34 New Park Horrabridge Yelverton PL20 7TF Lead Inspector Wendy Baines Unannounced 18th July 2005 9.30 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. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Davie House Address 33 & 34 New Park Horrabridge Yelverton Devon PL20 7TF 0116 279 3225 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) CARE (Cottage and Rural Enterprises Ltd) Mrs Susan Denise Batley Care Home 11 Category(ies) of Learning Disability (11) registration, with number of places Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: One named service user with Physical disability (PD) Date of last inspection 11th January 2005 Brief Description of the Service: Davie House is situated within the small village of Horrabridge, on the edge of Dartmoor in West Devon. The house is set in its own grounds, with a large attractive garden area. Horrabridge has several local shops, pubs, churches and park areas and is also within easy reach of the main road into the neighbouring town of Tavistock. The home is currently registered to accommodate 11 service users with a Learning Disability and offers accommadation on two floors, which include large communal areas and single bedroom facilities. There is also a separate self-contained facility called Little Davie which has three bedrooms, a communal sitting room and kitchen and sepatate access. Little Davie has been used to promote independence, although service users continue to access facilities in the main part of the house. The Registered Provider for Davie House is Cottage and Rural Enterprises (CARE). CARE is a Registered Charity and is overseen by a Board of Trustees. The organisation is Registered to operate 29 services across England, and currently provides 26 care homes and 3 Domiciliary Care agencies for people with a Learning Disability. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and took place on the 18th July 2005, between 9.30 and 4pm. The Registered Manager for the home is Mrs Susan Batley and she was present throughout the inspection. Since the last inspection the Registered Provider has sent monthly internal inspection reports to the Commission for Social Care inspection and the Registered Manager has provided reports when necessary and contacted the Commission for advice and support when required. A tour of the premises took place and a sample of records relating to service users, staff and the management of the home were inspected. The majority of the service users were spoken to during the inspection as were all staff on duty. What the service does well: Service users are encouraged and supported by the staff to make decisions and choices about their lives and very much consider Davie House to be their home. Prospective and current service users are provided with sufficient information regarding the home and the services provided. Following admission a care plan is developed for each individual outlining the support required and this information is regularly monitored and reviewed. When needs are more complex clear guidelines are documented to ensure that staff are aware of the reasons for the support and the way the care should be delivered. Service users are supported and encouraged to make choices about their lives and those spoken to said that staff listen to their views and concerns. Health needs are documented and monitored regularly and the home liaises with a range of health workers to support them with this area of care. The organisation has a positive approach to training and training opportunities are explored to ensure that staff have the skills to meet the changing needs of service users. Staff are well supported by a regular supervision and an open, inclusive and positive style of management. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 6 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. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 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 Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 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) 1,2,3,4. The homes Statement of Purpose and service user guide provide service users and prospective service users with sufficient information regarding the home and the services provided. Service users are included in decisions regarding changes to the home and the care they receive. The homes assessment and daily monitoring systems provide information to the staff to enable them to ensure that service users needs continue to be met. EVIDENCE: A Statement of Purpose and Service user guide is available for current and prospective service users and contains details of the facilities and support available. The Registered Manager said that the Registered Provider, Cottage and Rural Enterprises (CARE) have been working closely with service users and staff to consider and discuss the long- term plan for the home and services it provides. The home has a written admissions procedure, which includes a pre-admission assessment. However, Mrs Batley advised that since the last inspection there has been no new admissions. Individual records are kept for each resident and these contained assessments, care plans, risk assessments and behaviour guidelines, all of which had been recently reviewed. Ongoing evaluation is recorded daily. The Manager and staff were able to demonstrate a good understanding of the changing needs of Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 9 residents living in the home, and records confirmed that staff undertake relevant training to address these needs. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 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 standard(s) 6,7,8,9,10. The homes care planning process, daily monitoring and record keeping provides staff with sufficient information to meet service users needs. Service users are enabled to participate in, and make decisions about all aspects of their lives. Service users can trust that their personal information will be treated with confidence and kept safe at all times. EVIDENCE: Each service user has a care plan and risk assessments that are regularly reviewed. A sample of these records were seen during the inspection. Care plans included a personal statement by the service user and details of how the individual wishes to be supported with daily care needs. Service users were supported by staff to documented their wishes and needs within their own Person Centred Plan and individual copies of this information were kept in service users rooms and reviewed as part of the care plan process. Staff were very aware of the care needs of service users, and daily monitoring, record keeping and regular ‘ hand over’ meetings ensures continuity of care. The Registered Provider and staff within the home have organised a range of opportunities for service users to be involved in discussions regarding the Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 11 home and any changes to the way services are provided. The attitudes and approach of the staff team promotes independence and empowers service users to make decisions about lifestyles and daily routines, demonstrating excellent practice. The manager said that service users have a range of skills relating to money, and receive support dependent on individual need. This information was not recorded within service user plans. Service user records were found to be well maintained and up to date. All information of a personal nature was recorded sensitively and stored safely within locked filing cabinets. There is a separate staff office, which is kept locked when not in use. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17. The atmosphere of the home was warm and welcoming. Service users are encouraged and supported to maintain and learn life skills, attend work/ educational placements and participate in any community and leisure activities. Service users are encouraged and supported to maintain and develop relationships with family and friends. Service users are offered a healthy diet and special dietary needs are met. EVIDENCE: On the morning of the inspection some service users were busy getting ready to go out for the day and others were enjoying a relaxing breakfast or starting morning chores around the home. The atmosphere was happy and welcoming and felt like any other busy home environment. Information in care plans, as well as talking with service users showed that they were enabled to live as full a life as they wish and had opportunities for personal development. Service users are encouraged to take part in a range of work, education and leisure opportunities. Those spoken to were keen to tell Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 13 me about these arrangements and particularly plans for holidays during the summer and BBQs they had recently enjoyed in the garden of the home. Staff were observed talking with services before going off duty and wishing them well for the day. It was evident that the needs of some service users have recently changed due to age and deteriorating health. The Registered Provider will need to ensure that care plans continue to reflect these changes and outline how staff will support service users within the home. Contact with relatives and friends is encouraged and there were no restrictions in place regarding visitors to the home. The majority of service users living in the home have special dietary requirements. This information was recorded and when the care was considered more complex had been documented as a separate plan detailing how the care should be delivered. Staff demonstrated a good understanding of the individual dietary needs of service users and records confirmed that staff undertake relevant training and liaise with outside agencies when required. Service users are encouraged to participate in shopping and menu planning, and drinks and snacks are available throughout the day. Observation on the day of the inspection confirmed that mealtimes were relaxed and unrushed. Staff were observed providing sensitive 1:1 support to service users requiring assistance with eating. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,21. Service users receive support in the way and at the time they want and need. Healthcare needs are addressed as soon as they are identified. Specialist advice and support is sought when necessary and much consideration is given to meeting the changing needs of service users due to illness and/or the ageing process. EVIDENCE: Service user plans provided information about personal, emotional and health care needs. Daily recording and charts were up to date and were regularly analysed to identify any changes in a service users health. Where healthcare needs have been assessed as more complex separate plans have been recorded outlining the care required, the responsibilities of the home and other agency involvement. The manager advised that these plans are reviewed with the support and input of specialist health services. An example was given of positive feedback from hospital staff regarding the homes care plans and how this information helped staff support the service user during his stay. Records confirmed that the home was liaising closely with the Learning Disability service for Dementia screening and relevant clinical guidance, and the Physiotherapy and Occupational Therapy services for advice relating to manual handling and adaptations for the home as service users needs change. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 15 Records confirmed that staff attend relevant external and in-house training specific to the current and changing health needs of service users. Service user plans documented how individuals wish to be supported with daily personal care needs and staff were observed offering support sensitively and respectfully, and asking the service user first before entering their bedroom. The manager and staff demonstrated a good understanding of the changing needs of service users due to illness/ and or the ageing process. Regular reviews were taking place for service users with Dementia. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Service users are protected from abuse, neglect, and self -harm. Staff awareness of individual needs and the homes complaints procedure ensures that all service users have the opportunity to express their views and concerns and have these matters addressed. EVIDENCE: Neither the home nor the Commission for Social Care Inspection have received any complaints regarding the service during the last 12 months. The home has a complaints procedure, and staff spoken to recognised the need to ensure that all service users are able to express their views and concerns. The manager said that staff have a good understanding of the communication methods of each individual and a range of opportunities including, formal and informal discussions, key-worker meetings and Person Centred Planning are used to ensure that everyones views are considered and acted on. The manager and staff were aware of Adult Protection procedures and a copy of the Alerters Guide and local Guidance was available. Records confirmed that staff undertake Adult Protection Training. Behaviour Management guidelines were documented for some service users and records confirmed that these had been agreed as part of a multi-agency meeting and were regularly reviewed. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,30. The standard of the environment within this home is good providing service users with an attractive, homely and safe place to live. The home regularly seeks outside support to ensure that the environment meets the changing needs of service users. EVIDENCE: On the day of the inspection the home was found to be clean and tidy throughout. Several service users were attending to daily chores either independently or with support from staff. It was evident through discussion and observation that service users consider Davie House to be their home and the tasks are an important part of their daily routine. A sample of service user bedrooms were seen and these were found to be bright, nicely decorated with furnishings and décor to reflect and meet individual needs. The bathrooms, toilets, kitchen and laundry area were clean and tidy, with notices and signs provided regarding health and safety and the control of infection. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 18 Discussion with the manager confirmed that consideration is being given to the longer term care needs of service users and any changes that may need to be made to the environment to meet these needs. Records confirmed that the home liaises closely with the specialist Learning Disability services regarding the environment and the needs of service user with Dementia, and other health needs. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36 Staffing levels are regularly reviewed to ensure that needs continue to be met. The manager is supported well by the staff team. Senior staff provide clear leadership throughout the home with all staff demonstrating an awareness of roles and responsibilities. EVIDENCE: Staff numbers on the day of the inspection were sufficient in number to ensure that individual needs were met as well as allowing time for staff handover and completion of daily records. The Registered Manager was not included on the rota and was therefore able to be present throughout the inspection and support staff with plans and arrangements for the day. The manager said that staffing levels were being reviewed due to the changing needs of service users with Dementia and other health and age related issues. The staffing structure ensures that a senior member of staff is on duty at all times, and the rota confirmed this information. It was evident through observation that staff have a good understanding of the needs of service users and communicate any concerns/ issues to the manager and other staff on duty. Staff were observed supporting each other and recognising each others strengths and skills. Records confirmed that in addition Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 20 to informal support, structured supervision takes place on a regular basis. This information is recorded and covers all areas as listed in the standards. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 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 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) 37,38,40,41,42,43. The Registered Provider includes staff and service users in plans relating to the home and services provided. The management approach is open, inclusive and positive providing clear guidance and leadership. Staff moral is high resulting in an enthusiastic workforce that work positively with service users to improve their whole quality of life. EVIDENCE: The Registered Manager has been in post since the home opened and has invested much time in supporting staff and service users through the recent change of Registered Provider. Mrs Batley is currently undertaking the Registered Managers award and records confirmed that she also undertakes a range of training opportunities relevant to the home and individual service users. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 22 Through discussion it was evident that the Registered Provider is working closely with service users and staff to consider current legislation and long term plans for Davie House and the services provided. Staff spoken to said they felt well supported and were included in matters regarding the home and the organisation. Service user spoken to also said that they have attended meetings and are able to express their views. All documentation relating to service users was up to date and stored safely. Documentation seen relating to health and safety, such as risk assessments, the accident book and fire log book were available and up to date. All staff complete training in safe working practices. Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 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 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Davie House Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score 3 x 3 3 3 3 3 D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 24 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 YA6 Good Practice Recommendations The Manager should include information regarding service user finances within the service user plan. This should detail; the skills of the service user, the type of support required and the reasons for support. This information should be reviewed as part of the care plan process. The Manager should ensure that service user plans continue to reflect changing needs, particularly in relation to the changing needs of service users with Dementia. The care plan should outline how staff will service users who are spending more time within the home environment. 2. YA12 Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Davie House D54-D07 S63500 Davie House V231833 120705 Stage 4.doc Version 1.30 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!