Inspection on 31/12/05 for Davie House

This inspection was carried out on 31st December 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 18/07/05

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 Devon PL20 7TF Lead Inspector Wendy Baines Unannounced Inspection 18th October 2005 10:00 Davie House DS0000063500.V249639.R01.S.doc Version 5.0 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 Davie House DS0000063500.V249639.R01.S.doc Version 5.0 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. Davie House DS0000063500.V249639.R01.S.doc Version 5.0 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 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) 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 DS0000063500.V249639.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user with Physical disability (PD) Date of last inspection 18th July 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 accommodation 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 separate 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 DS0000063500.V249639.R01.S.doc Version 5.0 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 October 2005 between 9.30 and 2pm. The Registered Manager for the home is Mrs Susan Batley and she was present throughout the inspection. A pre-inspection questionnaire had been completed and sent to The Commission for Social Care Inspection. A tour of the premises took place and a sample of records relating to service users’, staff and the management of the home were seen. The inspector was able to speak with several service users and the staff on duty and was also invited to join everyone for lunch. The atmosphere of the home was warm and welcoming. What the service does well: What has improved since the last inspection? The Registered Manager and staff have continued to look at the homes care planning and recording processes to ensure that the information is clear and easily accessible. There has been particular attention given to the documentation relating to service users where needs have changed significantly due to ill health. Clear guidelines were available for staff, which Davie House DS0000063500.V249639.R01.S.doc Version 5.0 Page 6 had been agreed between the home and Health care professionals and staff were very aware of these agreements. Since the last inspection the home have completed Residential/community skills assessments of all service users. The manager said that this information has assisted staff to write more detailed care plans and to monitor and address any changes in need. 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 DS0000063500.V249639.R01.S.doc Version 5.0 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 Davie House DS0000063500.V249639.R01.S.doc Version 5.0 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): 3&5 Staff have the skills and information required to meet the current and changing needs of service users. There are clear agreements between the home and service user about the care and facilities provided. EVIDENCE: Individual records are kept for each service user, and these include assessments, care plans, risk assessments, and behaviour management guidelines where necessary. All records seen were found to be well maintained and up to date. The management and staff demonstrated a good understanding of each individual’s communication methods, behaviours and changing needs due to health and/or the ageing process. Records confirmed that as needs change the information available to staff is amended to ensure continuity of care. Each service user has a Local Authority contract and/or a Statement of Terms and Conditions, which outlines the facilities and services they should expect to receive from the home. Davie House DS0000063500.V249639.R01.S.doc Version 5.0 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 the following standard(s): 6,7,8. 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. EVIDENCE: Each service user has a care plan and risk assessments, which are regularly monitored and reviewed. Service user plans contained detailed information, and specific guidelines for staff where needs were considered more complex. Since the last inspection staff have completed a residential and community skills assessment (ABS- Adaptive Behaviour Scale) for each service user. The Registered Manager said that key-workers have been involved in the assessment process and the information drawn from this has enabled staff to monitor and be aware of any changes in service user needs. This has been particularly helpful for one service user with Dementia. It was evident that staff have been able to use the information gathered from the assessment to access additional services and to draw up a more detailed care plan and guidelines for staff. Throughout the inspection staff were observed supporting all service users to make choices and decisions about their arrangements for the day. Several Davie House DS0000063500.V249639.R01.S.doc Version 5.0 Page 10 service users were being supported to attend a meeting regarding the modernisation of care services and changes that may ultimately affect them. Staff were observed at lunchtime supporting one service user who requires a high level of care due to health needs. It was evident that staff are very aware of the guidelines relating to this particular service user and were observed treating him with dignity and respect at all times. Davie House DS0000063500.V249639.R01.S.doc Version 5.0 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): 11,12,14,16. The atmosphere of the home was warm and welcoming. Service users are encouraged and supported to maintain and learn life skills, participate in a range of leisure activities, and make decisions / choices about their daily routines. EVIDENCE: On the day of the inspection the atmosphere of the home was warm and welcoming. Several service users were getting ready to go out, and others were enjoying an unrushed and relaxing breakfast. Although the inspection was unannounced service users are used to people visiting the home and were keen to sit and chat with the inspector. Information in care plans as well as talking with service users confirmed that they are enabled to live as full a life as they wish and had opportunities for personal development. Person Centred planning and Participatory Appraisals involving social services have been supporting service users and staff to consider long- term care needs and individual goals and aspirations. The Registered Manager said that service users are involved in all discussions regarding leisure and activities, and staff were currently considering how to pursue a request for more art and craft opportunities in the home. Davie House DS0000063500.V249639.R01.S.doc Version 5.0 Page 12 Records confirmed that the home had recently made a referral to the Learning Disability Psychology Department to support them with a service user who due to ill- health would be spending more time in the home. Staff spoken to were to ensure that his needs were being adaquatly met. The care plan included clear guidelines for staff and it was evident through observation that this information is understood and being followed. Davie House DS0000063500.V249639.R01.S.doc Version 5.0 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): 20. The systems for the administration of medication are good with clear and comprehensive arrangements in place to ensure service users medication needs are met. EVIDENCE: Service users have a range of skills relating to the management of their healthcare needs. This information is documented within each service user plan. Where service users are able to self- administer medication risk assessments have been completed and individual lockable storage space provided. An assistant manager was able to provide clear details of the homes medication procedures during the inspection. Records are kept of all medicines received, administered, and disposed of. The home operates a Boots ‘ Medisure ‘ system and a record is kept of the current medication for each service user. The assistant managers are responsible for administering medication and a second staff member countersigns to say the medication has been given. Records confirmed that staff responsible for administering medication attend regular training. The Manager said that a visit from the Boots pharmacist had been planned as there had been several new members of staff appointed. All medication is safely stored and there is separate storage and recording for controlled drugs. Davie House DS0000063500.V249639.R01.S.doc Version 5.0 Page 14 Davie House DS0000063500.V249639.R01.S.doc Version 5.0 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): Not inspected on this occasion. EVIDENCE: Not inspected on this occasion. Davie House DS0000063500.V249639.R01.S.doc Version 5.0 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): 24,25,26,27,29,30 The standard of the environment within the home is good providing service users with an attractive, homely and safe place to live. The home seeks support from other specialist agencies 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. A sample of service user bedrooms were seen and these were found to be bright, pleasantly decorated with furniture and décor to meet individual needs. The bathrooms, toilet, kitchen, and laundry area were clean and tidy, with notices and signs provided regarding health and safety and the control of infection. Care plans and discussions with staff confirmed that the home had liaised with the Physiotherapy and Occupational Therapy services regarding the need for specialist equipment for one service user. A Pivotal bed and Cradle hoist had been purchased and records documented clear guidelines for staff regarding the use of and care of this equipment. Davie House DS0000063500.V249639.R01.S.doc Version 5.0 Page 17 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): 34,35. The homes recruitment procedures are thorough and ensure the protection of service users. The home has a positive attitude to training. The staff team have the skills and experience to meet the needs of current service users. Training is regularly updated to ensure that current and changing needs continue to be met. EVIDENCE: A sample of staff records were seen during the inspection. There have been some new members of staff appointed since the last inspection and these files were looked at in more detail. The records confirmed that applicants had completed a detailed application form, with details of past employment. Files also contained two written references, ID and Criminal Record checks. In addition to this required documentation files also contained a check- list for the Registered Manager to ensure all necessary details are gathered and a list of questions from service users regarding prospective staff members. All staff members have an individual training plan. Information provided as part of the homes pre-inspection questionnaire confirmed that of the 14 care staff, 3 are completing NVQ 3 in care, 4 undertaking NVQ 2 and the remainder registered with the Learning Disability Award Framework to complete induction/ Foundation training. Records confirmed that all staff undertake fire safety, manual handling, first aid, and food hygiene training and this is regular updated. In addition care staff and the Registered Manager undertake a range of specialised training relating to the home and specific service users including; Davie House DS0000063500.V249639.R01.S.doc Version 5.0 Page 18 Gastrostomy Feeding, Challenging Behaviour, Mental Health Awareness and Dementia Care. All staff have recently undertaken a comprehensive manual handling course specific to the needs of one service user. This training also included the use of equipment and supporting the service user to make choices regarding his care. Davie House DS0000063500.V249639.R01.S.doc Version 5.0 Page 19 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): 37,38,39, The management approach is open, inclusive, and positive providing clear guidance and leadership. Staff and services users are consulted and participate in decisions regarding the home. Staff moral is high resulting in an enthusiastic workforce that work positively with service users to improve the whole quality of their lives. EVIDENCE: The Registered Manager has been in post since the home opened and continues to invest much time in supporting staff and service users through a number of recent changes. 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. Staff and service users said they felt included in discussions and decisions regarding the home and felt that their views were listened to and acted on. On the day of the inspection several service users were being supported to attend a meeting regarding care services and changes that may ultimately affect them. Service users are also supported to attend weekly advocacy meetings Davie House DS0000063500.V249639.R01.S.doc Version 5.0 Page 20 and service user questionnaires are completed as part of the homes quality Assurance system. Davie House DS0000063500.V249639.R01.S.doc Version 5.0 Page 21 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 x x 3 x 3 Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 4 3 x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 x 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 x 14 3 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Davie House Score x x 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x x x DS0000063500.V249639.R01.S.doc Version 5.0 Page 22 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 Davie House DS0000063500.V249639.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ashburton Office 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. 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