Inspection on 02/02/06 for Deanbrook

This inspection was carried out on 2nd February 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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Deanbrook 20/05/08

Deanbrook 09/05/06

Deanbrook 23/06/05

Deanbrook 22/10/04

Deanbrook 13/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Deanbrook Totnes Road South Brent Devon TQ10 9BY Lead Inspector Wendy Baines Unannounced Inspection 2nd February 2006 10:00 Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 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 Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 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. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Deanbrook Address Totnes Road South Brent Devon TQ10 9BY 01364 72446 01364 72446 deanbrook@havencare.plus.com 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) Havencare (Plymouth) Mrs Elizabeth Frances Bannister Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 6 service users who have a learning disability and are aged over 18 years may be accommodated at any one time Adults with a learning disability who may also have a physical disability may be accommodated 23rd June 2005 Date of last inspection Brief Description of the Service: Deanbrook is a large converted bungalow close to the centre of the village of South Brent. The home is owned by Havencare, (Plymouth) a voluntary organisation specialising in caring for adults with a Learning Disability. Deanbrook is registered to provide care for six people with a learning disability who may also have a physical disability, including those aged over 65 years. The home caters for people with a high level of needs. The accommodation comprises of five single, and one double bedroom. There is a large communal lounge, separate dining room and large conservatory, which opens onto extensive gardens. The property is all on one level with specialist bathing and toilet facilities for service users with a physical disability. Deanbrook has its own transport, which is used extensively and has access to the shops and facilities within the village. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on the 2nd February between 10pm and 2pm. The Registered Manager Mrs Elizabeth Bannister was available throughout the day. All service users have very limited verbal communication and are unable to comment on the quality of the services provided. However, all service users were at home and the inspector was able to spend time observing the care provided, sampling records, and discussing each individual with the manager and staff on duty. A sample of care plans, Person Centred plans, Risk assessments and daily records were inspected as were Health and Safety records including the Fire log and accident/incident charts. There was a tour of the building and all service user bedrooms were inspected. The inspector was invited to stay to lunch and was therefore able to observe the care of service users during this time. The atmosphere of the home was warm and welcoming. What the service does well: Deanbrook provides good, individualised care and support for the people who live there. The staff team is small and many have worked in the home for several years and are very familiar with the individual needs of service users. A thorough and detailed assessment is undertaken regarding every aspect of care and clear guidelines are set out for staff detailing how the care should be delivered. Each service user has a key-worker and support team who work hard to ensure that service users are able to make choices and be cared for in a way that they prefer. The home regularly liaises with the Primary Health care services and Learning Disability department to ensure that needs continue to be met as individuals become older and their health needs change. Staffing levels are high and allow for service users to partake in a range of opportunities inside and outside the home. The accommodation is comfortable and attractive and the Provider continues to consider ways of improving the facilities to meet changing needs. The management approach is open and inclusive. Staff moral is high resulting in an enthusiastic workforce that work positively with service users to improve their whole quality of life. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 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. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 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 Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 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): 1,5. Service users can be confident that the home will provide appropriate information to enable them and their representatives to make an informed choice about where they live and the care they receive. EVIDENCE: A written statement of Purpose and Service user guide is available for prospective and current service users. This includes information about the home and services provided. Since the last inspection the home has started to consider how this information can be provided in a format more accessible to each individual. Each service user now has a booklet with a collection of photographs of the home. Discussion took pace with the manager about the need to further develop this information to include signs and symbols relating to the services provided. The home has a written admissions’ procedure, however there have been no new service users since the home opened approximately 16 years ago. All service users have a Local Authority contract and a written Statement of Terms and Conditions between the home and the individual. This information should be signed by the home and Service user/representative. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 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): 6,7,8,9,10. The home has a clear, consistent and Person centred care-planning system, which provides staff with the information they need to satisfactorily meet service users needs and enable individuals to make choices about their care. EVIDENCE: A sample of Care plans and Person- Centred plans were made available for inspection. The home undertakes a thorough assessment of every aspect of an individuals care needs. This information is translated into a detailed care- plan for the home, which includes short and long- term goals, strengths and support needs, and clear guidelines for staff. The format and content of this information confirmed that much consideration is given to service users choice, rights and personal preference. Details are included about an individuals preferred choice of support from when they wake up in the morning and throughout their day. Much of this information has been translated into signs and symbols and is regularly reviewed and updated. All service users also have a Person Centred Plan and staff have received appropriate training to support this approach. There is a PCP team for each service user, which may include staff, family and other people involved in their care. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 11 Examples were given of one service user being supported to make choices about a holiday destination. A range of information had been gathered to assist the choice making process including; brochures, photographs, signs and symbols. Staff demonstrated a good awareness of how each service user communicates and the manager said that the home regularly liaises with the Speech and Language services to further develop and support this understanding. Risk assessments have been written for all activities inside and outside the home. These were found to be detailed, signed and included a date for review. Any restrictions and Behaviour management guidelines had been agreed as part of a multi-agency meeting and clear guidelines were available for staff. The manager said that this information is regularly reviewed as part of the care planning process. All records inspected were found to be well maintained, up to date and securely stored. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 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): 11,12,13,14,15,16,17. Much consideration is given by the home to ensure that service users can partake in a range of opportunities inside and outside the home. Service users can be confident that the home will support them to maintain links with family and friends. The meals in the home are good, offering both choice and variety and catering for special dietary needs. EVIDENCE: Service user Care plans and Person Centred Plans include information about personal development, social and leisure opportunities. This information is reviewed and updated as part of the care planning process. Specific arrangements are documented on individual activity planners. The manager said that due to Local Authority re-organisation several service users had experienced recent changes to their planned day care. Staff were aware of how these changes may affect each service user concerned and Person- Centred Planning meetings had been focusing specifically on these issues. In addition the home had liaised with outside agencies including the specialist Learning Disability services to assist them to support service users during this time. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 13 Deanbrook is situated within a small community on the edge of Dartmoor and service users are supported to access local facilities and enjoy regular trips in the homes mini-bus. All service users have a holiday each year, and are involved in choosing a destination. The manager said that arrangements were underway for a new activities room, and this would be available for use by all service users. Service users are supported to maintain contact with family and friends and it was evident that staff work hard to maintain close contact with elderly relatives when visits are no longer possible. Throughout the day staff were attentive and sensitive to the needs of all service users. When the inspector was shown around the house the staff knocked on the service users bedroom door before entering. Discussion took place with the Registered Manager regarding the need to ensure that the language used within daily records is appropriate and respects the rights and dignity of service users at all times. Service user records contained information regarding dietary needs and likes/dislikes. This information is used to plan a weekly menu. The inspector was invited to stay to lunch and was able to observe the quality of the food prepared and the care provided during this time. A choice of food was made available and was presented attractively. Service users were offered support when necessary but were also encouraged to eat independently without any need to rush. Staff were aware of service users who needed additional support and monitoring at this time. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 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): 18,19,21. Service users receive support in the way and at the time they want and need. Healthcare needs are monitored and any changes addressed as soon as they are identified. Specialist support and advice 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 records contained information regarding Personal, emotional and healthcare needs. Guidelines were available for staff setting out specific preferences and an individual’s routine for the day. All service users living in the home require a high degree of support in all areas of personal care, and staff were observed responding sensitively and respectfully to care needs throughout the inspection. Records confirmed that service users healthcare needs are addressed via services from the Primary Care team and specialist Learning Disability services. Records and discussion confirmed that staff are very aware of the changing needs of service users due to illness and/or the ageing process. Specialist Learning Disability Services have been involved with the home to undertake Health screening for Dementia and staff have attended training in this area of care. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 15 The manager advised that much consideration has been given to the care needs of service users with Dementia and issues relating to long- term care, the environment and family. Files contained a range of charts used to monitor service users health care needs and any changes that may occur, these include; a falls Register, weight and behaviour charts. The homes medication procedures and records were not inspected on this occasion. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 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 the following standard(s): 22. Staff awareness of individual needs and the homes complaints procedure ensures that any concerns are identified and dealt with promptly. EVIDENCE: There have been no complaints since the last inspection. The home has a written complaints procedure that has been effectively simplified and converted into pictures and symbols. This is displayed in the communal dining area. The home has a small, consistent staff team who have a good awareness of the service users needs and how each individual communicates. The Manager demonstrated a good awareness of the need for staff to use this knowledge and the systems in place to recognise and respond to any concerns. Discussion took place with the Registered Manager for the need to ensure that staff give a more objective account of an event or behaviour within the daily communication book to ensure that any re-occurring patterns of behaviour can be analysed and addressed. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 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 the following standard(s): 24,25,26,27, 28,29,30. Service users are provided with accommodation that is comfortable, attractive and clean. The home provides adequate bathing and toilet facilities for service users with a physical disability who currently live in the home. EVIDENCE: The inspector was able to see all communal parts of the house and service users bedrooms. All parts of the home were clean and tidy and the standard of furniture and décor was high. Service user bedrooms were attractively decorated with lots of personal items and décor to suit individual tastes and needs. Since the last inspection the communal bathroom and toilet have been fully refurbished to include walk-in shower, disabled bath and a range of grab rails. The hallway has been decorated and a new carpet fitted. There has also been a new roof for the conservatory and a new boiler as part of the bathroom refurbishment. The manager said that there is an ongoing maintenance and renewal plan for the year, which includes an inside activities area within the garden. There is a raised wooden threshold between the lounge and conservatory and this could be a tripping hazard for anyone with mobility difficulties. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 18 Discussion took place with the manager regarding the need for the home to consider arrangements for staff toilets, to ensure that staff and visitors are not required to use service users en-suite facilities. The manager advised that consideration has been given to the provision of hand washing facilities in the laundry area. Since the last inspection the home has provided staff with a dispenser hand scrub, however, this should be only be used short term whilst appropriate hand- washing facilities are provided. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36. Deanbrook has an experienced staff group who provide continuity of care for service users. Sufficient skilled staff are employed to meet the high levels of needs of service users. Staff receive the support they require to fulfil their role in the home. EVIDENCE: The home has a small and well- experienced staff team. Some have worked in the home for several years and have a good understanding of each individuals needs. All the staff spoken to during the inspection were able to give a clear account of the home, their own role and the role of others. Each staff member has a designated additional responsibility and are therefore made to feel very much part of a team. There is a staff- training programme and all new staff are registered to undertake Induction/Foundation LDAF training. Each staff member has a training profile and all are in the process of NVQ training. In addition staff and management undertake health and Safety statutory training and a range of inhouse and external courses including; Dementia care, Loss & Bereavement, Total Communication and Adult Protection. There were sufficient staff on duty to address the high levels of needs of service users. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 20 The manager advised that staffing levels are reviewed regularly and this was a particular focus at the time due to the change of planned day care arrangements for some service users. Agency staff are occasionally used to cover annual leave and sickness. The manager said that the home makes efforts to use the same agency to ensure consistency and documented evidence is requested to confirm ID and the completion of satisfactory Criminal Record Bureaux checks. In addition to daily support and hand over meetings staff have formal 1:1 supervision every six weeks. There is an agreed format for these meetings and all details are documented. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,40,42. Service users and staff benefit form an open, positive and inclusive style of management. Staff moral is high resulting in an enthusiastic workforce that work positively with service users to improve their whole quality of life. EVIDENCE: Mrs Elizabeth Bannister is the Registered Manager for the home and was available throughout the inspection. Mrs Bannister has worked within the home for 2 years and previously worked within senior managements posts in other homes owned by the organisation. She is currently undertaking the Registered Managers award and has NVQ 3 in Mental Health and NVQ 4 in management and Care. Mrs Bannister also has a NVQ assessor qualification and undertakes regular training as part of the homes on-going training programme. Throughout the inspection there was a feeling of staff being open and supportive and working closely as a team to ensure that service users needs are met. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 22 The home has a designated senior member of staff who is responsible for all health and safety checks. Records were found to be well maintained and up to date. Risk assessments had been completed for activities inside and outside the building. The Health and Safety representative was aware of recent changes to Food Hygiene Standards and had requested the necessary information to incorporate these changes into the homes policies and procedures. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 x 3 x 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 x ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 2 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 x 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 x 3 3 4 x 3 x 3 x Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 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 YA24YA24 Regulation 23 Requirement Timescale for action 10/03/06 2. YA30YA30 23 The Registered Provider must undertake a risk assessment of the raised wooden threshold between the lounge and conservatory to determine any risks for service users with limited mobility. In addition to hand gel, the 10/10/06 Registered Provider must provide adequate hand washing facilities in the laundry area. 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 2 Refer to Standard YA1YA1 YA16YA16 Good Practice Recommendations The Registered Provider should continue to develop the service user guide, to include appropriate signs and symbols relating to the services provided. The Registered Provider should ensure that the language used within daily records is appropriate and respects the rights and dignity of service users at all times. DS0000003684.V280080.R01.S.doc Version 5.1 Page 25 Deanbrook 3 YA22YA22 4 YA28YA28 The Registered Provider should ensure that staff give a more objective account of an event or incident of behaviour when reporting in the daily records, to ensure that any reoccurring patterns of behaviour can be analysed and addressed appropriately. The Registered Provider should review the current arrangements for staff toilets to ensure that it is not necessary for staff or visitors to use service users en-suite facilities. Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 26 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. Extracts may not be used or reproduced without the express permission of CSCI Deanbrook DS0000003684.V280080.R01.S.doc Version 5.1 Page 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. 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. 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