Inspection on 04/07/05 for Dee House

This inspection was carried out on 4th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Dee House 04/08/06

Dee House 10/01/06

Dee House 11/01/05

Dee House 06/07/04

Dee House 12/02/04

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

CARE HOME ADULTS 18-65 DEE HOUSE 20 SEALAND ROAD CHESTER CHESHIRE CH1 4LB Lead Inspector ANTHONY GROOM Announced 4 JULY 2005 09.30 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Dee House Address 20 Sealand Road Chester Cheshire CH1 4LB 01244 375820 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Muir Group Housing Association Limited Ms Joy Swainson Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 9 service users in the category MD (Mental disorder, excluding learning disability or dementia). 2 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 11 January 2005 Brief Description of the Service: Dee House is care home for nine people who have mental health needs which is owned and operated by Muir Group Housing Association Limited. Located on Sealand Road, within a mile of Chester City Centre, the home was opened in 1991 and extended in July 2000 to provide three additional places. The premises comprise two terraced properties linked by a conservatory extension to the rear. Accommodation for residents comprises nine single bedrooms (dispersed between two floors), two lounge areas, a dining room, kitchen and separate laundry. Standards of décor, furnishings and fittings are good throughout the home, as are standards of hygiene and cleanliness. Residents are encouraged to participate in the running of the home, and they are supported by staff to make full use of community facilities/amenities for shopping, recreation, education and healthcare. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection commenced at 9.30 a.m. on 4 July 2005 and was carried out by Anthony Groom over four hours thirty minutes. The manager, deputy manager and two support workers were on duty and nine people were living at the home. During the inspection seven residents were spoken with, a range of records were examined and a tour of the premises was undertaken. Prior to the inspection, comment cards were sent to the manager for distribution to residents, relatives and professionals involved with the home. At the time of the inspection, 14 completed cards had been returned. What the service does well: What has improved since the last inspection? A written policy on Quality Assurance has been compiled by Muir Group Housing Association Limited. This is currently being implemented and should lead to the home being able to provide more written evidence of consultation with residents, relatives and other people who are involved with the home, such as nurses, doctors and social workers. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 6 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. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 All residents are assessed before they come to live at Dee House so that they and their families know that the home will be able to meet their needs. EVIDENCE: All residents are admitted to the home under Care Programme Approach (CPA) arrangements. The care files for three residents were reviewed and all contained evidence that a comprehensive assessment of their individual needs had been carried out by the manager, who is a qualified nurse (RMN), before they moved into the home. All residents considered that the home was fully meeting their needs, and this was echoed by very positive comments from three Community Psychiatric Nurses (CPN’s) and a Consultant Psychiatrist who all have a professional involvement with Dee House. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8 and 9 All residents have an individual care plan which identifies their individual needs and how staff provide support in order to meet these. Residents are involved in all decision-making about their daily lives and this helps to promote and maintain their independence and enhances their quality of life. Risk-taking is well managed and this protects the safety of people who live at the home. EVIDENCE: Three care plans were examined and all contained relevant and current information about the needs of the individuals concerned and the support required by staff to ensure that these were being met. Care plans are signed by residents and reviewed at least every three months. There was evidence of the involvement of other mental healthcare professionals in the care of residents i.e. Community Psychiatric Nurses (CPN’s) and Consultant Psychiatrists. Written comments from CPN’s were received, and these included: “I feel that the care Dee House clients receive is of the highest standard, and would be happy to place anyone there. The clients are visibly happy and well looked after”. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 10 “I have always found Dee House to be friendly and inviting. The staff are kind and thoughtful in their interactions with the service users and indeed with visiting professionals such as myself”. A Consultant Psychiatrist also commented “I am very impressed with the overall input from the professionals working at Dee House”. Residents said that they knew about their care plans and that they were fully involved in the process of writing them and reviewing them. Residents said that they felt they were involved in making decisions about their daily lives and about routines in the home. These included how they spend their time, what interests and hobbies they pursue, what food they eat, how they decorate and furnish their bedrooms, what they spend their money on and where they go for their holidays. Where residents are involved in activities or situations where there is a possibility of them harming themselves or others, risk-assessments are carried out and management strategies are agreed with the individuals concerned and reviewed on a regular basis. Examples of individual risk-assessments seen included daily living skills, self medication, smoking, holidays and fishing. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14, 15, 16 and 17 Residents are well supported by staff to pursue activities of their choice, make decisions about their lives and become involved in their local community. This promotes a sense of fulfilment, enhances their quality of life and ensures that their individual rights are protected. EVIDENCE: Residents said that they really liked living at Dee House and it was very clear from their comments that they considered it to be their “home”. They spoke very warmly of the care and support they received from the manager and staff and were happy to talk about their daily lives and how they spent their time. Most residents go out independently – either individually or in small groups whilst two or three need some support or supervision from staff. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 12 A number of residents said that they regularly attend a specialist day centre in Chester which, in conjunction with the local college of Further Education, provides a range of recreational and educational activities including creative writing, relaxation classes, art classes, music groups and literacy/numeracy support groups. The centre also provides a ‘drop-in’ service where people can visit for a cup of coffee/tea and a chat with other local people who use the service. On the afternoon of the inspection three residents were preparing to leave to attend the ‘drop-in’ service. One resident talked of his interest in fishing and the fishing trips he goes on. A second spoke of his voluntary work as a disc jockey at a local club and his interest in art and painting and volunteered to show the inspector a portfolio of his work. Another resident takes responsibility for feeding and looking after the home’s pet cat. The home arranges in-house activities for residents (e.g. bingo, karaoke, dominoes, board and card games) as well as regular trips and outings. An annual ‘house holiday’ is arranged, but residents also go on short-break holidays in smaller groups. Three days before the inspection, residents had returned from a weeks’ holiday in Blackpool which everyone said they enjoyed. One resident also spoke of a short-break holiday in Germany which she and two other residents had gone on with two staff members earlier in the year. Residents said that they make full use of local community facilities for shopping, recreation and healthcare, including using public transport. Residents confirmed that they are, where applicable, supported to maintain regular contact with their relatives and friends either through entertaining them at Dee House or visiting them in their own homes. All residents are on the electoral register and they confirmed that they are able to vote in local and general elections if they wish – either in person or through the use of postal voting. Residents said that they are involved in compiling food menus, which follow a rotating cycle. They confirmed that alternatives are made available on the day, if requested. Staff were observed to consult with residents regarding what they wanted for lunch on the day of the inspection. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 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 standard(s) 18, 19 and 20 Staff are aware of the individual needs and preferences of residents and this enables them to provide care and support in accordance with their wishes. Residents are supported to hold and administer their own medicines, if they wish (and are able) and this promotes greater independence. EVIDENCE: Individual care plans and daily notes showed that residents’ needs had been identified and were being met by staff in accordance with their individual preferences. The home’s policies and procedures emphasise the importance of protecting residents’ privacy and dignity. All bedroom doors have locks fitted and residents have their own keys so that they can lock their doors if they wish. The three care plans seen were clear in showing what residents’ health and personal care needs were and how these were being met by staff. This ensures consistency in the way that care and support is provided. All residents are registered with a local medical centre and are able to use community healthcare facilities for dental, ophthalmic and chiropody services, where necessary. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 14 The home has written policies and procedures governing the management of residents’ medicines. A monitored-dosage system is used and, where applicable, residents sign a ‘consent to medication’ form as part of their individual care plan. Subject to an individual risk-assessment, residents are able to hold and administer their own medicines - which three individuals currently do - and lockable drawers are provided in all bedrooms. Residents expressed complete satisfaction with all aspects of the care and support they receive at Dee House. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 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 standard(s) 22 and 23 The home’s complaints procedure ensures that residents’ views are listened to and acted upon. Staff have received training so that they can protect residents from harm or abuse. EVIDENCE: A written complaints procedure, which included contact details for the Commission for Social Care Inspection (CSCI), was displayed within the home. Residents said that they were aware of how to make a complaint if they were unhappy with any aspect of the care and support they receive at Dee House. No complaints have been received about the home by the CSCI. Written policies for the protection of vulnerable adults were in place and the home also had a copy of the local authority’s protocols and procedures for adult protection. Staff working at the home have received training in this area within the last twelve months. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 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 standard(s) 24 and 30 The home enjoys a good location and provides a clean, well-maintained, comfortable and homely environment for the people who live there. Residents said that they were very happy with their accommodation and that it fully met their needs. EVIDENCE: Dee House is an adapted property which provides accommodation for nine people. It is located within half a mile of Chester City centre and is in close proximity to a range of shops and other facilities/amenities. Accommodation for residents comprises nine single bedrooms, two lounges, dining room, kitchen and separate laundry. The home also has a pleasant, fully accessible and private garden area to the rear (containing flowerbeds, potted plants and garden furniture) which can be used by residents for relaxation. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 17 Standards of décor, furnishings and fittings were good throughout the home, as were standards of hygiene and cleanliness. The manager reported that the main lounge and laundry room were going to be redecorated within the next two months, and that replacement front windows were scheduled to be fitted to the original part of the home during the current financial year. She also reported that outstanding work to convert the existing staff toilet into a staff shower-room/toilet was due to commence in the near future. Residents expressed complete satisfaction with the standard of accommodation provided at Dee House. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 35 Dee House has a well trained, committed and stable staff team who know the people who live at the home very well. This ensures that residents’ individual needs are met effectively and with respect and sensitivity. EVIDENCE: Relationships between staff and residents were observed to be warm, relaxed and friendly, and this clearly benefits those people who live at the home. Five staff members have completed NVQ training – three at Level II and two at Level III – and the manager reported that two further staff members were scheduled to commence NVQ Level II training in September 2005. Staff rosters confirmed that previously agreed staffing levels were being maintained at the home. Muir Group Housing Association Limited (who own and manage the home) demonstrate a commitment to staff training and development. Discussion with the manager, duty staff members and an examination of training records confirmed that staff undertake training in a range of areas. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 19 Examples of training undertaken included: medicine administration, first aid, manual handling, basic food hygiene, risk-assessment, mental illness, needs assessment and review, stress management, diabetes awareness and holistic care. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 Dee House is a well run home. It has a qualified and experienced manager and residents receive care and support from a staff team who know them well. The views of residents are sought in order to monitor and improve the quality of the service provided. The management of health and safety within the home is taken seriously and this offers protection for residents and staff. EVIDENCE: The home’s manager is a qualified nurse (RMN) who has been in post for over seven years. She completed NVQ Level IV training (the Registered Managers’ Award) in May 2005 and is awaiting presentation of her certificate. As part of her own professional development, she undertakes regular in-service training which enables her to carry out her role effectively and ensures that her staff team provide a high standard of care and support for residents. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 21 Muir Group Housing Association Limited have recently (May 2005) compiled a specific Quality Assurance policy for Dee House. The document sets out how the home is monitored and is part of a process of continuous improvement in the quality of service provided to residents. It includes obtaining the views of residents, their families and other stakeholders as well as regular auditing of record systems and procedures within the home. The manager reported that she is currently in the process of compiling an annual development plan for the home in consultation with residents and staff. A tour of the premises and an examination of written documents (i.e. fire precaution records and equipment maintenance records) confirmed that health and safety within the home was being well managed through staff training and safe working practices. DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 DEE HOUSE Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 3 x F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 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. 1. Standard Regulation None. Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard None. Good Practice Recommendations DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit D, off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 DEE HOUSE F51 F01 S6547 Dee House V229381 040705 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!