Inspection on 13/09/06 for Dean House

This inspection was carried out on 13th September 2006.

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

Dean House 19/02/09

Dean House 24/11/08

Dean House 17/02/06

Dean House 03/10/05

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

CARE HOME ADULTS 18-65 Dean House 267 Wellingborough Road Rushden Northants NN10 9XN Lead Inspector Mrs Helen Wilson Unannounced Inspection 13th September 2006 16:00 Dean House DS0000063723.V311168.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 Dean House DS0000063723.V311168.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. Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dean House Address 267 Wellingborough Road Rushden Northants NN10 9XN 01933 350225 01536 726496 deanhouse@communitycaresolutions.com www.communitycaresolutions.com Community Care Solutions Limited 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) Vacant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th February 2006 Brief Description of the Service: Dean House, operated by Community Care Solutions Ltd, provides personal care for a maximum of nine adults with care needs due to Learning Disabilities. The premises are located anonymously in a Victorian terrace within easy walking distance of the small towns shopping centre and local leisure facilities. Service users share a communal living area, dining room, kitchen, two bathrooms and one shower room facility. There are five single bedrooms and two double rooms. Laundry services are provided in-house. The current range of fees is from £ 542.75 to £1527.35. Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is on outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of the service that need further development. Prior to the visit the inspector had looked at written documentation about the home including any reports of incidents, accident and complaints and had planned the inspection to coincide with the return of the service users from their various day centres and work places. No-one at the home knew that a visit had been planned and during the inspection there were two care staff and seven service users present. The manager was on holiday so the senior carer helped host the inspection. The primary method of inspection used was ‘case tracking’ which involved selecting two service users and tracking the care given to them by reviewing the selected case records. The inspector spoke with the service users and staff, observed the evening meal and noted the interaction of people in the home. Requirements and/or recommendations identified at the previous inspection were reviewed. All had been met. There were no immediate requirements or recommendations made at the time of the visit. What the service does well: An application for registration of the manager has been submitted to Commission for Social Care inspection following the period of induction and probation at Dean House. Written information is clear and explains to the reader in a mixture of words and pictures what it is like to live at Dean House. There is clarity about each person’s care needs and care plans give good guidance to staff on how to care and support the individuals living at the home. Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 6 People living at the home have grown in confidence and told the inspector that they like the staff and enjoy their day centres. Service users ate their evening meal together in a family type setting. The food looked and smelled delicious. Each service user is registered locally with GP, dentist, optician where necessary and receive other specialist healthcare where identified. Medication records showed that service users are given their prescribed medication regularly. The home’s daytime and night staffing levels have increased in response to one person’s care and health needs. Service users and staff go shopping together for the weekly food shopping and several people went out during the inspection to buy chocolate/sweets from the local shop. The home operates in an open manner that would enable people to raise any concerns. Dane House has been successfully updated to a bright comfortable home with good facilities that suit the service users. What has improved since the last inspection? What they could do better: The service users have been given more opportunities at the home to take part in ordinary routines and household tasks. Dean House staff have shown ability in making positive changes and can continue to help individuals to develop living skills and make independent choices. Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 7 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. Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 8 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 Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information available to service users and their families is sufficient to judge the suitability of the home. Service user’s individual needs and goals have been re-assessed. EVIDENCE: Case files showed that the home has issued a Statement of Purpose and a Service User Guide to each service user living in the home. These documents are clear and explain to the reader in a mixture of words and pictures what it is like to live at Dean House. All the people have lived at the home for many years. Case files showed that the staff have drawn together good assessments of the service users’ care needs from their knowledge of each person and from any information provided by families and outside agencies. In both case files examined there were contracts and terms and conditions for living at Dean House. Dean House DS0000063723.V311168.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): 6,7,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides care and support planned around the individual service user’s needs. EVIDENCE: It was noted form two case files that care plans and risk assessments had been cross-referenced and are now appropriately detailed to ensure that staff have full guidance on how specific care is to be given. There is clarity about each person’s care needs and how people can be encouraged to develop ordinary living skills. Service users are helped by staff to manage their personal monies. Bank accounts are held for large savings, invoices are issued for monthly charges/payments, and small amounts of cash are held securely for people to make purchases at local shops. Staff routinely recorded money given to service users for personal spending during the inspection visit. All records relating to service users are locked away securely. Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 11 Dean House DS0000063723.V311168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,14,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home continues to make good progress in supporting service users to have ordinary and appropriate lifestyles. EVIDENCE: This inspection highlighted the progress service users have made in their confidence in talking to visitors to the home. Everyone told the inspector what he or she had done during the day, some people spoke about their holiday to Skegness and two people spoke about their visits to a local social club. One person used Makaton signing to make conversations clear. Service users attend two day centres with long established transport arrangements in place. One service user travels independently on the bus to work at TeamWork in Wellingborough packing components for despatch. Although she said she enjoys working there, she told the inspector that “sometimes it is boring”. Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 13 The service users said they liked to go to the local Gateway Club where they play board games. The evening meal was prepared by one carer and was ready for the return of the service users from their day placements. Consisting of shepherd’s pie, mashed potatoes and a mixture of vegetables, fruit and custard, the meal was enjoyed by the service users who then helped tidy away and dry up the dishes. Menus are planned on a weekly basis but the meals prepared are switched around and alternatives provided are not recorded. Staff said that they will raise this with the manager to see how this record should be kept. One service user has had little interest in food in recent months but has again started to enjoy his food and ate very well. Dean House DS0000063723.V311168.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 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 area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that service users are helped to access healthcare services appropriately. EVIDENCE: Each service user is registered locally with GP, dentist, optician where necessary and receive other specialist healthcare where identified. Both case files looked at by the inspector showed that the home involves healthcare professionals appropriately and confidential records are kept of health matters. The home has made appropriate contact with the local GP surgery for the referral of service users to other health care professionals such as the continence advisor, the cardiac consultant and community/hospital consultants. Medication administration record sheets are signed off by staff and there were no gaps in the recording of drugs given to the service users. No-one holds their own medication and all supplies are locked away for safety. Dean House DS0000063723.V311168.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 in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home operates in an open manner that would enable people to raise any concerns. Protection of Vulnerable Adults procedures are correctly followed and external agencies involved to protect people who live at Dean House. EVIDENCE: Service users were seen to have a warm interaction with staff and were confident in their conversations. There have been no complaints raised about Dean House in recent months. There has been an incident outside of the home that required investigation by external agencies using Protection of Vulnerable Adults procedures and the home’s manager initiated this process appropriately. As a result of the investigation a staff member will accompany service users on activities in the community. Dean House DS0000063723.V311168.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): 24,25,26,27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Dane House has been successfully updated to a bright comfortable home with good facilities that suit the service users. EVIDENCE: Dean House is a homely and recently redecorated house; there is a garden to the rear where service users can walk or sit on their own. Bedrooms are mostly repainted and service users have personalised the rooms with small items, toys or pictures. One service user has a computer, most people have a television or CD player. Service users choose whether to join with the others in the lounge and dining room or spend time in their bedrooms in the evening. A double bedroom has recently been refloored with washable vinyl and is currently being used as a single due to the health needs of a service user. Bathrooms and shower facilities are of high quality and service user’s individual needs are met. Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 17 The home was clean, tidy and hygienic. One person uses a walking frame in the home. During a walk round the premises it was noted that a few window restrictors were not being properly used and potentially a safety risk to service users. The carer on duty reported these in the maintenance log for urgent attention. Dean House DS0000063723.V311168.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 and 33 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Current staffing levels are appropriate to the needs of people at the home. EVIDENCE: Staff are friendly and communicate well with people living there. Some care staff have been working with the service users for many years and this has given stability to the home in the past months while newly recruited staff are introduced. Dean House staff have shown ability in making positive changes and can continue to help individuals to develop living skills and make independent choices. The home’s daytime and night staffing levels have increased in response to one person’s care and health needs. The manager also works on three shifts per week supporting service users to develop their individual abilities. During the inspection visit there was a lot of shared laughter and conversation between staff and service users. Service users said they liked their carers. Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 19 Dean House DS0000063723.V311168.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): 37,38,40,41,42 and 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a positive manner. The needs of service users are being focussed on appropriately. EVIDENCE: An application for registration of the manager has been submitted to CSCI. Standard 37 will remain unmet until a manager is registered in respect of the home. An Area Manager visits the home monthly and checks that the home is being run and operated to satisfy the company’s procedures. Monthly reports are forwarded to CSCI and confirm that checks are carried out such as water temperature, room temperatures and call systems weekly and that fire protection and fire evacuation procedures, maintenance carried out and emergency lighting checked on a monthly basis. Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 21 The home has established policies and procedures that are available and guide staff. Case file records are organised and daily entries are made. Insurance cover is held. The company has a business and financial plan for the home and this inspection has again shown that development of the home is progressing. Dean House DS0000063723.V311168.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 3 2 3 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 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 x 14 3 15 X 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 1 3 x 3 3 3 3 Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 23 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 Dean House DS0000063723.V311168.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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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