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Inspection on 19/05/08 for Dell Residential Home (Sudbury)

Also see our care home review for Dell Residential Home (Sudbury) for more information

This inspection was carried out on 19th May 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The design and layout of the Dell promotes ordinary living arrangements for small groups of up to six service users. Service users have appropriate pre admission assessments before they move into the home so that they are clear that their needs can be met. Staff recruitment checks are thorough and care staff are appropriately trained and competent to do their jobs. Service users are able to raise concerns directly with the managers and feel that their views are taken seriously and acted upon.

What has improved since the last inspection?

Since the last inspection there has been significant progress and the seventeen outstanding requirements have been met. Person centred care plans are now in place for everyone living at the home and include evidence of reviews, updates and risk assessments. They also indicate that service users are consulted about their personal care and how it isprovided. Continence care is managed more pro actively to ensure peoples dignity is respected. Staffing numbers have increased and bungalows no longer close because of staff shortages. Although some `gaps` remain significant improvements have been made to the environment, including repairs to showers, work to comply with fire regulations and decoration and refurbishment. The kitchen has also been refurbished and appropriate food hygiene procedures are in place.

What the care home could do better:

Although person centred care plans have been introduced they need to be developed so that they are more detailed and clearly reflect service users, needs, wishes and preferences in all areas. There are still some shortfalls with regard to meals, particularly around promoting opportunities for less independent service users in terms of choice and participation. It is also recommended that insulated containers or similar equipment is provided to maintain the temperature of hot food when it is transported from the kitchen. The administration of insulin by care workers for one service user means that the service user does not have unreasonable routines to follow. However, the systems in place to safeguard them from harm need to be more robust. For example there must be a robust risk assessment in place, a clear protocol and evidence of specialist staff training and assessment. Attention to environmental issues such as water damaged carpets and walls must be dealt with by the organisation in a more timely manner. Maintenance of the premises and grounds needs to be less reactive and more pro active. The matter of a lack of hand washing facilities in laundry areas needs to be addressed so that infection control procedures are not compromised.

CARE HOME ADULTS 18-65 Dell Residential Home (Sudbury) Cats Lane Great Cornard Sudbury Suffolk CO10 2SF Lead Inspector Tina Burns Unannounced Inspection 19th May 2008 1:30 Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dell Residential Home (Sudbury) Address Cats Lane Great Cornard Sudbury Suffolk CO10 2SF 01787 311297 01787 313385 the.dell@craegmoor.co.uk www.craegmoor.co.uk Speciality Care (REIT Homes) Ltd 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) Kelly Marie Cox Care Home 48 Category(ies) of Learning disability (48) registration, with number of places Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th April 2007 Brief Description of the Service: The Dell is a permanent care home for adults with a learning disability. It was first registered in 1987 as a core and cluster home where small groups of service users are accommodated in bungalows, each bungalow forming a selfcontained unit. Over time, additional bungalows have been built to bring the home to the present capacity of 48. The current registered owners, Speciality Care (Reit) Homes Ltd, purchased the home in 1995 and agreed that the Dell had reached its maximum desired capacity. Speciality Care was acquired by Craegmoor Healthcare Ltd in March 1998. The bungalows accommodate up to six people and have their own communal areas, laundry facilities and some catering facilities. They are grouped around a central administration block that also includes the main kitchen and day care area. Access to the site is by a private drive that is shared with some immediate neighbours. The home is situated within a quiet residential area with good links to Sudbury town centre. The buildings are modern, purpose-built units and offer a good standard of accommodation. All service users have good-sized private bedrooms all have a wash hand basin. At the time of inspection fees started at £485.00 per week but varied according to assessed needs. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an unannounced key inspection, which focused on the core standards relating to care homes for Adults. The report has been written using accumulated evidence gathered prior to and during the inspection. Regulation inspector, Tina Burns, undertook the inspection over a two day period. The process included a tour of the premises and examination of a wide range of documents and records including three service user care plans and three staff files. The inspector also met and spoke with several people who live and work at the Dell. Information has also been gathered from the home’s Annual Quality Assurance Assessment (AQAA) submitted to the Commission in December 2007, and survey forms completed by 6 service users, 6 service user’s relatives and six members of staff. The registered manager and deputy manager were on duty at the time of our visit and fully contributed to the inspection. What the service does well: What has improved since the last inspection? Since the last inspection there has been significant progress and the seventeen outstanding requirements have been met. Person centred care plans are now in place for everyone living at the home and include evidence of reviews, updates and risk assessments. They also indicate that service users are consulted about their personal care and how it is Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 6 provided. Continence care is managed more pro actively to ensure peoples dignity is respected. Staffing numbers have increased and bungalows no longer close because of staff shortages. Although some ‘gaps’ remain significant improvements have been made to the environment, including repairs to showers, work to comply with fire regulations and decoration and refurbishment. The kitchen has also been refurbished and appropriate food hygiene procedures are in place. 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. The summary of this inspection report can be made available in other formats on request. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users can expect to have the information they need to make an informed choice about whether the home will meet their needs. EVIDENCE: Feedback from staff, service users and relatives and examination of records confirmed that the home has appropriate assessment and pre admission procedures in place. This means that informed decisions can be made about whether or not the home is appropriate and can meet the individual’s needs. Service users’ records examined included copies of their local authority assessments and pre admission assessments that had been undertaken by the home. The assessments covered a wide range of physical, social and emotional needs, such as health, safety, finances, personal care and physical well being, eating and drinking, mobility, elimination, pain, sleep, mental health, communication and social interaction. The home’s Service User Guide had been designed with the needs of the client group in mind and included pictures, symbols and large print. Records Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 9 examined indicated that service users new to the home were given support to read and understand the document. At the time of the visit Bungalow 7 had just been refurbished and was not in use. Consequently there were six vacant places. The manager explained that they were in the process of consulting social care services about the needs of local people with learning disabilities before making a decision about the admission criteria for that bungalow. Further discussion indicated that the manager was clear about the homes responsibility to ensure that the service they intended to provide was appropriate in relation to their registration, and their ability to meet the needs of both new and existing service users. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home are being consulted about their needs and receiving an increasingly person-centred service. EVIDENCE: People spoken with and records examined evidenced that the home had made significant progress with service users care plans since the last inspection. Everyone living at the home had a new care plan in place that had been completed using the company’s Person Centred Care Planning booklets. The care plans were in a style that promoted service user consultation and a needs led approach to individuals care. They included a personal profile and life history and covered areas such as relationships and social contacts, health and keeping safe including specific risks to self and others, personal care, mental health and behaviour, communication and independence. The manager advised that the development of the care plans had been a lengthy process due to the need to complete them at a pace suitable to the service user involved. Further Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 11 detail was required in some sections of the three care plans examined to ensure that the individuals needs, likes, dislikes and preferences were clear but overall the progress was very positive, further more the manager demonstrated a clear commitment to the continued development of the plans so that residents can be assured that staff will approach and respond to their needs safely and effectively. Observations made, records examined and feedback received confirmed that people living at the Dell are appropriately supported to make individual choices and decisions. Assessments and care plans included information about individual’s personal preferences and mental capacity. Advocacy and befriending schemes were used appropriately, particularly for service users that had no involvement from their families. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home can expect to enjoy a range of activities at home and in the community but they cannot be sure that they will always be satisfied with their meals. EVIDENCE: At the time of inspection the home’s activity co-ordinator post was vacant and the day care area called ‘The Zone’ was not operational. The manager advised that the post had been vacant since March and at that point they had not successfully recruited a replacement. However, feedback received and observations made during the inspection confirmed that people were supported to participate in a wide range of activities at home and in the community. Activities included Horse riding, art and craft, music and aroma therapy. Some of the service users also attended Sudbury resource centre and others were Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 13 involved in the local Bridge project and ASDAN course at the local college. In addition evidence indicated that people living at the home are routinely supported to get out and about and enjoy activities such as shopping and going to local cafes and pubs. The manager also advised that approximately fifty percent of the service users had relatives that were actively involved in their lives and five had been ‘matched’ with be-frienders from the Mencap scheme. Photographs displayed around the home also evidenced that birthdays and special occasions were routinely celebrated and links with the local community were being forged through events such as summer fetes and displays of Art work. Several service users who were spoken with during the inspection talked about some of their personal plans and achievements and indicated that the home supported them to maintain and develop their independence. This was particularly evident in bungalow 5 where two of the people living there were keen to talk about their daily routines and aspirations for the future. Since the last inspection the kitchen had been fully refurbished and was suitably equipped to cater for the home. Discussion with the cook confirmed that they had responded appropriately to the last environmental health report and addressed the issues raised regarding food hygiene procedures. At the time of inspection the kitchen provided main meals for twenty two service users in four of the bungalows. Of the other four bungalows, one was completely vacant and three did their own menus, shopping and cooking. Breakfast and evening meals were prepared in the individual bungalows. Main meals provided by the kitchen were kept hot in a hot trolley until staff came and transported the food in large plastic boxes to each bungalow. It is from this point that the food can no longer be kept hot. People having a meal provided by the kitchen chose from a rotating four week menu two days in advance. On the second day of inspection the main meal served in one of the bungalows was minced beef cobbler, mashed potatoes and fresh vegetables. It was served to residents immediately it arrived from the kitchen so that it was still hot. The meal looked and smelled appetising; however it was dished up by staff in the kitchenette area and not served at the table. It was noted that plastic crockery was in use although the manager and deputy manager advised that it would be replaced with something more suitable, up until then they had not been aware that plastic crockery was in use. The manager advised that the budget for food was approximately £735.00 per week. This means that each person was allocated a budget of just under £18.40 per week. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home can expect to become increasingly confident that their personal and healthcare needs will be met in a way that reflects there preferences and respects their dignity. EVIDENCE: Since the last inspection service users’ care plans had been developed to include their preferences about personal care and whether or not they are happy to be assisted by care staff of the opposite gender. However, records examined did not include evidence of how individuals had been consulted regarding this matter. The manager advised that it was their intention to fully record decisions regarding this issue at future reviews where the service user, their care manager and family members or representatives would be present. For new service users the matter was addressed as part of the initial assessment process. Concerns raised at the last inspection about the management of staff shortages and the practice of sending service users to other bungalows had been addressed. People spoken with confirmed that staffing numbers had Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 15 increased and individuals were not expected to move to other bungalows at times of staff sickness absence or leave. Discussion with the manager, records examined and feedback received confirmed that practice relating to the provision of personal care had improved. Comments indicated that staff were generally more pro-active about promoting service users privacy and dignity and where appropriate continence care was included in service users care plans. Observations made and feedback from staff and residents also indicated that issues relating to disability access had been addressed and staffing in the bungalows had been increased according to the needs of the residents. Observations made and records examined confirmed that overall the home had appropriate procedures in place for the safe storage, recording and administration of medication. Staff responsible for handling medication had also undertaken medication training. However, systems in place to enable the home to safely administer insulin to one service user with diabetes were not suitably robust. The individuals care plan did not include a clear protocol for administration and although staff spoken with confirmed that they had been trained by a specialist nurse, records of the training or an assessment of their competencies were not in place. Further more there was not a full and thorough risk assessment that had been signed and agreed by all relevant parties including the responsible healthcare professional. Feedback received and records examined indicated that people living at the home are supported to access community healthcare services. Records included information about individual’s health care needs, health care instructions and outcomes of health care appointments. Individual care plans included information about “When I become sick or might die”. The home had begun to complete them in consultation with service users or their representatives as appropriate and according to individual’s needs and circumstances. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can expect to have their views listened to and acted upon. Further more they can expect to be protected from abuse. EVIDENCE: The homes complaints procedure was displayed in the main building and individual bungalows in a style that was suitable for the people living at the home. Eleven out of the twelve surveys returned by service users and their relatives confirmed that they knew how to make a complaint and raise concerns. Records examined and information provided in the homes Annual Quality Assurance Assessment (AQAA) indicated that there had been two formal complaints made since the last inspection in April 2007. Both had been appropriately addressed. There was also good evidence that service users routinely talk to the manager and deputy manager about how things are going for them and any issues or concerns are identified and addressed before they become complaints. These discussions had been recorded on “chit chat” sheets and were held in their personal files. Since the last inspection the home reported one safeguarding incident relating to a medication error and this was duly investigated. Feedback from staff and records examined confirmed that staff had undertaken training in the Protection of Vulnerable Adults. Whistle blowing procedures and procedures for staff or visitors to report concerns were displayed in the entrance to the main building. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to find accommodation that is comfortable, generally clean and homely. However, maintenance tends to be reactive rather than proactive and this places staff and residents at potential risk. EVIDENCE: Since the last inspection significant refurbishment and internal decoration had taken place within the main building and bungalows. The hole in the ceiling of bungalow 4 and the showers in bungalows 1,2,3 and 4 had been repaired, however the walls and carpets that had suffered water damage still needed attention. Overall each bungalow provided a relaxed, comfortable and homely environment. Bedrooms seen were personalised and reflected individual’s interests and personalities. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 18 Contrary to findings at the last inspection, the grounds had begun to look unsightly and the outside of the bungalows looked worn and uncared for. One window in bungalow 3 was boarded up because the frame had rotted and the window had fallen out. The bell on the door of bungalow 2 had also “dropped off” and some of the external paintwork was “shabby” and unsightly. The manager explained that all of these matters were in hand. A request for new windows throughout the site had been submitted, although at that point not approved, and they had just filled a vacant gardener/maintenance workers post. Discussion with the manager about appropriate call bell and alarm systems revealed that staff in the bungalows were now equipped with pagers to summon assistance if required. The main kitchen had been fully refurbished since the last inspection and was fitted with appropriate equipment, including a dishwasher. The cook confirmed that the kitchen was much easier to keep clean. At the time of inspection the areas seen were clean and free from unpleasant odours. A tour of the bungalows revealed that some laundry areas did not have hand wash facilities and this was a concern in terms of infection control as it was not clear where staff washed their hands after handling dirty laundry. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receiving a service are safeguarded by robust recruitment procedures. Further more, they can expect to be supported by staff that are appropriately trained and competent to do the job. EVIDENCE: Three staff recruitment records were examined and included all documentation required including photographs, evidence of ID, evidence of CRB checks, application forms, references and health checks. Staff spoken with and records seen also confirmed that care workers undertake appropriate training in areas such as Protection of Vulnerable adults, health and safety, fire awareness, infection control and manual handling. New staff are expected to complete a “skills for care” handbook as part of their induction programme. Over fifty percent of care workers employed hold or are working towards NVQ level two in care or above. Feedback from staff, service users and relatives and discussion with the manger confirm that staffing levels have increased since the last inspection. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 20 The manager advised that the bungalows are now staffed according to the needs of the occupants. Comments included “The staff situation has improved a lot in the past 6-12 months”, “There are always enough staff on shift now” and “The deputy and manager step in if there is high sickness”. Feedback from care workers confirmed that they felt appropriately supported by their line managers. A programme of regular formal supervision and team meetings was in place. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 & 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are benefiting from the management approach of the home. Further more, their health, safety and welfare is promoted and protected. EVIDENCE: Since the last inspection the acting manager Ms Kelly Cox has become the permanent manager of the home and her registered manager’s application was approved by the commission in March 2008. Kelly Cox is qualified with NVQ 4 in care and holds the registered manager award and the assessors’ award. Comments received by the Commission indicate that Ms Cox is a competent manager who has led improvements at the home and built positive Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 22 relationships with staff, service users and relatives. Comments received included: “Changes have been slow but sure”, “I can’t tell you how much better it’s been”, “The service is continually improving”, and “Much improved since arrival of new manager”. The seventeen requirements made at the last inspection were reviewed at this inspection and found to be met. In addition discussion with the manager about ‘gaps’ identified during the inspection demonstrated a clear commitment to comply with legislation and continue to raise standards at the home. Quality Assurance procedures in place included monthly provider visits and a wide range of audits undertaken by the manager or representative from the company. Audits covered areas such as financial administration, health and safety, medication and person centred care plans. The homes Annual Quality Assurance Assessment (AQQA) had been submitted to the Commission in December 2007. It provided some useful information but some sections could have been more detailed so that it was clear what the home does well and where it intends to improve. The manager advised that although people living at the home were consulted through individual reviews and residents meetings the intention was that the future activities co-ordinator would lead the development of the company’s “your voice” initiative at the Dell. The manager confirmed that all outstanding work regarding the matters raised following a fire inspection in 2006 had been carried out. A tour of the premises and records seen also confirmed that routine maintenance and health and safety tests and checks are carried out, for example fire alarm and fire equipment tests, water temperature checks, manual handling equipment checks and portable electrical appliance tests. Further more training records indicated that staff undertake appropriate health and safety training such as infection control, food safety, manual handling, fire safety, first aid and control of substances hazardous to health (COSHH). Procedures for reporting accidents and incidents were in place and notifications required by the Commission have been made. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 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 3 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 3 3 3 2 X X 3 X Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 YA20 Regulation 13(2) Requirement Timescale for action 27/06/08 2. YA20 13(2) 3. YA20 13(2) 4. YA24 23(2)(b) There must be a thorough and robust risk assessment in place for the service user who is administered insulin by care workers. The risk assessment must be signed and agreed by all relevant parties including the responsible health professional. This is to safeguard the service user from harm. The care plan of the service user 27/06/08 who is administered insulin must include clear guidelines for staff responsible for the administration. This is so that the service user is safeguarded from harm. There must be evidence that 27/06/08 staff responsible for administering insulin have been trained and assessed as competent by an appropriate health professional. This is to safeguard the service user from harm. The damage caused by water in 31/07/08 the corridors of bungalows 1, 2, 3 and 4 must be addressed so that they are not unsightly and are maintained in a sound DS0000024372.V364867.R01.S.doc Version 5.2 Dell Residential Home (Sudbury) Page 25 condition. 5. YA30 16(2)(j) The lack of hand washing facilities in the laundry areas without hand basins must be addressed so that service users are safeguarded from harm. 31/07/08 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 YA17 YA17 Good Practice Recommendations The home should look at ways of promoting service user choice and participation at meal times. Equipment, such as insulated containers, should be used to transport hot food to the bungalows so that appropriate temperatures are maintained. Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Dell Residential Home (Sudbury) DS0000024372.V364867.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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