Inspection on 19/02/09 for Dean House

This inspection was carried out on 19th February 2009.

CSCI found this care home to be providing an Good service.

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 24/11/08

Dean House 13/09/06

Dean House 17/02/06

Dean House 03/10/05

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Dean House 267 Wellingborough Road Rushden Northants NN10 9XN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ann Wiseman     Date: 2 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Dean House 267 Wellingborough Road Rushden Northants NN10 9XN 01933350225 01536726496 deanhouse@communitycaresolutions.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Community Care Solutions Limited care home 9 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 9 Dean House care home is registered to provide personal care to male and female service users who fall within the following categories: Learning disability (LD) 9 The maximum number of persons to be accommodated at Dean House is 9. Date of last inspection Brief description of the care home Dean House is operated by Community Care Solutions Ltd and is registered to provide accommodation for a maximum of nine adults with learning disabilities. The premises are located in a Victorian terrace house within easy walking distance of Rushden shopping centre and local leisure facilities. People living there share a communal living area, dining room, kitchen, two bathrooms and one shower room facility. Laundry services are provided in-house. The current range of fees is from £542.75 to £1527.35 a week. 2 4 1 1 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection; we arrived at 10.00am in the morning and stayed for three hours. The manager was on duty and facilitated the inspection, which she did in an open and helpful manner. Whatever files and documents we asked to see were quickly produced and were well ordered. During the visit we had a look around the home and talked to a member of staff. We also had an opportunity to speak with the area manager. We looked at information belonging to three people and the available information of three of the staff. We also assessed some of the homes policies and procedures and sampled a random selection of the health and safety files and records. Care Homes for Adults (18-65 years) Page 5 of 27 Before the inspection the manager had sent us the Annual Quality Assurance Assessment (AQAA) she had completed. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the service. The AQAA was sent to us within our set timescales and showed that the home recognised areas that need further improvement. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Adults (18-65 years) Page 7 of 27 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People thinking of moving into Dean House are offered enough information to enable them to make an informed choice about the home and everyone has their care needs assessed before they move in. People can visit and test drive the home to see if they like it and will be given a contract if they decide to stay. Evidence: Dane house is a small home with nine beds, and the people who live there have been together a long time. Two people have recently moved on but as yet the beds havent been filled so there havent been any new admissions recently, but during discussions with the manager it was evident that she understood the need to properly assess people to make sure that the service would meet their needs and to make sure that they would fit in and get on with the other people already in the home. She assured us that people considering moving into the home are invited to visit before hand to test drive the service. They will be invited to dinner and to have overnight visits. The placement will be reviewed after six weeks. Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: We were told in the AQAA that, Transition into the home is individually tailored and carefully managed by the staff and is reviewed by the manager. Dean House is part of Community Care Solutions Ltd and their corporate polices, procedures and guidelines are used by the home. The statement of purpose and the residents guide carry all of the required information and are written in a clear and easily understood style with pictures and widgets. The manager has told us in the AQAA that it was planned to review and improve both the documents in the near future. We examined two peoples files during this inspection and found that they contained assessments done by the home and good quality care plans derived from the assessment. We saw copies of the contracts that are given to people and noted that they set out the terms and conditions of the placement. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home have detailed care plans and they are assisted to make decisions about their life and are consulted about the way they want to live. People who live in the house are enabled, through risk assessments, to take some risks as part of an independent lifestyle. Staff are trained to respect confidences and to handle personal information in a way that will maintain confidentiality. Evidence: We examined two peoples personal information including their care plans; they reflected the needs and aspirations of the person involved. The manager has updated them since the last inspection and they have been reviewed at regular intervals. The files showed that people who live in the home are enabled to make decisions about the home and the things they do. Monthly meetings are held where they are able to discuss the running of their home. We were told that an external advocate attends both the care plan reviews and the house meetings. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: In the AQAA we asked what the home does well in this area, the manager wrote that, We use one to one consultation with people to ascertain their personal aspirations to follow an independent lifestyle as much as possible. While examining the care files, we saw that they contained risk assessments that are developed to minimise risk of harm in peoples every day activities without restricting them unduly. The manager told us that staff induction training includes the importance of keeping peoples confidences and that she will monitor that it is upheld on a daily basis and challenge infringements during supervision. When not in use we saw that private information is stored in a cupboard and we were assured that it is not left lying around in communal areas. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities are offered in and out of the house that makes people a part of the local community. Friends and family are welcomed in the home and peoples rights and responsibilities are recognised and upheld. Food offered to people is varied and meals are eaten in comfortable surrounds. Evidence: People attend a day centre and there is a planned activities program of individual people, which are centred on encouraging people to live their lives to their full potential. The home has its own transport people can access and trips are organised to the cinema, pub and other local amenities and people are given the option to attend if they want to. We saw that peoples religious preferences are recorded on their care Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: plans and people are supported to attend religious services if they choose. However the manager told us that there was no log of what activities take place and who attended them. It is important that a central record is kept of planed activities and if they went ahead, so that the manager can monitor which activities are popular. It will be a useful tool to evidence that the home is proactive in providing activities that are tailored to meet peoples individual needs and aspirations. The manager assured us that families and friends are welcomed into the home and are invited when the home has a party or BBQ. We also saw evidence of family visits recorded in peoples daily notes. People are helped to keep their rooms clean and tidy and go food shopping with staff and help chose the meals. The menus we saw show that the home offers a varied and nutritious diet. The dinning room is a homely and attractive area where people can sit comfortably to enjoy their meals. We looked in the food cupboards, freezers and fridges; they were well stocked with fresh, tinned and frozen food as well as snacks and treats. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home records peoples personal care needs in a way that enables them to be supported as they want to be. People have access to doctors and specialist care and medication is managed properly. Evidence: We looked at two peoples care plans and found that their support needs were recorded and they were written in a way that reflected peoples personal preferences. The care plans had been reviewed regularly. People are supported to look after their own personal care needs as independently as possible. Daily log entries written by staff confirm peoples daily progress and were up to date. We found evidence, in the files we examined, that people have access to medical practitioners as and when they need to, they also get support from specialists such as consultants, psychology, psychiatric, dentists and opticians. We examined the medication and its records and found that they were as required. There were no recording errors or omissions and the medication is stored appropriately. Care Homes for Adults (18-65 years) Page 16 of 27 Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaint policies and procedures are in place and we saw that if any were received, all complaints would be investigated and dealt with appropriately. Systems are in place to properly record complaints and concerns. We also saw evidence that people are protected from abuse by staff being properly trained in safeguarding and managing challenging behaviour. Evidence: The home has complaint and safeguarding policies and the complaints procedure is displayed in the home. On the 30th November 2008 we carried out a random inspection. We had been contacted by the relative of someone livening in the home, they were concerned that the room their relative slept in was very cold because the windows didnt close properly and the heating in the room was not sufficient to keep the room warm. The room also appeared damp and there was black mould on the windows frames. When we arrived at the home the manager told us that she was aware of the concerns as they had already been raised with her and that she was in the process of assessing the situation. She was open in the way she answered our questions and agreed that the situation needed to be addressed. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: We were given a tour of the home and we paid particular attention to the areas raised in the complaint, we found that most of the house was comfortably warm, but the rooms that had been complained about were cold. There are three rooms in an older part of the house, they were single glazed and had storage radiators that didnt adequately heat the room. The manager undertook to take action to rectify the situation. During this inspection she showed us that the windows in that area of the house had been replaced with double glazed units and the heating had been improved. The issue was dealt with quickly and we believe that it was a good outcome for the people who have bedrooms in that part of the house. Several requirements where made during the random inspection, mainly to do with the heating in peoples rooms and monitoring that the rooms were kept warm until a permanent solution could be found. All of those requirements were complied with before this inspection. At the moment the manager doesnt record issues raised as concerns in her complaints book. It is considered good practise to record concerns alongside complaints to show that the home takes all problems bought to their attention seriously and indicates a willingness to act on them. Also, by keeping a record of all concerns in one place, it allows the manger to monitor them better and to pick up on trends and patterns. House meetings are held where people are invited to attend and share their views about the home. An advocate attends the meetings and records are available for residents and staff to refer to. The home keeps us informed of any incidents and situations that may have an adverse effect the lives of the people who live in the home via regulation 37 notifications and the manager told us that all staff undertake safeguarding, whistle blowing and managing challenging behaviour training, we saw evidence that the training takes place on staff personnel files. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is safe, comfortable, clean and hygienic. Bedrooms suit peoples needs and lifestyle and there are sufficient bathrooms and toilets. Evidence: We were shown around the whole building and we saw that it is set out in a domestic style and is homely, comfortable and clean. The company has a maintenance team to manage the ongoing program of maintenance and decoration to the communal areas and peoples rooms. Bedrooms were all individual and reflected the personality of the occupant, with personal belongings, pictures and furniture. Some people keep fish in their rooms and are encouraged to look after them independently. There are sufficient bathrooms and toilets to meet peoples needs and some have been fitted with equipment and aids to maximise independence. The garden is well presented and easily assessable. People help to maintain the garden which is laid out with easy to maintain plants and bushes. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are aware of their roles and responsibilities and are qualified. The home has recruitment policies and procedures in place that are being followed and that are designed to protect people from abuse. Appropriate training is in place and the staff receive supervision. Evidence: Staff personnel files are normally kept at the organisations head office and can be seen on request. We arranged to see the files when we visited another service that is managed by the same company a couple of weeks later. When we saw the files we found that they held all the information and documents that are required and were very well organised. All of the people living in the home were at their day centre and only one staff member was on duty while we were at the home, we spoke to her and she confirmed that all the checks that safeguard people are being carried out before staff start work at the home. We noted that there is evidence in the files that people receive supervision and that regular staff meetings are held and that staff are encouraged to add items to the Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: agenda. The care staff we spoke with displayed a good knowledge of the people in the home and understood their needs. Information given to us in the Annual Quality Assurance Assessment (AQAA) completed by the manager, tells us that the home has met the minimum of 50 of its staff having attained the NVQ 2 in care or its equivalent. The staff records show evidence that the home offers the required training to its staff. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is well run and the ethos of its management is empowering to the people living in it and their views underpin its running. The policies, procedures and the record keeping protect peoples rights and best interests. Health and safety is promoted with the necessary checks being made and records kept. Evidence: The manager has been working at the home for just under a year, she is an experienced manger who is also running another small home close by owned by the same company. The people in the two homes have been closely connected over the years, they are friends with each other and socialise together. This means that she already knew everyone living in this home and during discussions with her about them she proved to be knowledgeable about their needs and her attitude was supportive and empowering. On this visit, and on our previous random inspection, we observed the way she spoke to people and staff and it was evident she has a good relationship with them. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The manager is qualified and continues to maintain her own personal development and continues to attend training. She facilitated the inspection in an open and friendly manner, was open to suggestions and talked about the plans she had to improve the quality of service offered to the people in her care. She was able to find everything we asked for and had sent us the annual quality assurance assessment (AQAA) when we asked for it. The home sends annual surveys to staff, people in the home and their relatives. Once they are returned the information is collated and action is taken when shortcomings are highlighted. House meetings are held where people are encouraged to speak their mind about how the home is run and how it can be improved. We are told in the AQAA that the companies polices and procedures are reviewed and updated as legislation dictates and that a quality and compliance manager has been appointed who oversees this area within the company and visits the homes individually to support the manger and to offer advice on how to maintain standards. A management development program for senior staff has also been implemented. During the visit to the home we saw that records are kept up to date and are stored appropriately. Personal details are stored in a cupboard and are not left unattended, staff are asked to read and sign the organisations policy on confidentiality during their induction. A sample of health and safety records was inspected and was found to be in order. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 It is recommended that a central record is kept of planed activities and if they go ahead, so that the manager can monitor which activities are popular. It will be a useful tool to evidence that the home is proactive in providing activities that are tailored to meet peoples individual needs and aspirations. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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. 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