Inspection on 16/06/05 for Derriads

This inspection was carried out on 16th June 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

Derriads 21/01/09

Derriads 16/07/08

Derriads 01/05/07

Derriads 27/06/06

Derriads 06/12/05

Derriads 27/01/05

Derriads 15/09/04

Derriads 24/03/04

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 Derriads Respite Care Home 70 Derriads Lane Chippenham Wiltshire, SN14 0QL Lead Inspector Alyson Fairweather Unannounced 16th June 2005 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. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Derriads Respite Care Home Address 70 Derriads Lane Chippenham Wiltshire SN14 0QL 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) Wiltshire County Council 01249 652814 To be confirmed Care Home 4 Category(ies) of LD Learning Disability (4) registration, with number LD(E) Learning Disability - over 65 of places Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 4 service users with learning disabilities, or learning disabilities over the age of 65, at any one time. Date of last inspection 27th January 2005 Brief Description of the Service: Derriads is an extended bungalow situated in a quiet residential area on the outskirts of Chippenham. The home provides respite care for up to four service users at a time, who have severe physical and learning disabilities. The home is owned and managed by Wiltshire County Council. The manager and staff team also run Meadow Lodge, which is part of the Chippenham Respite Service. There is 24 -hour staff cover to provide support for service users. Derriads is an attractive home, with a large lounge and comfortable furnishings. There is a separate dining room, a kitchen and two bathrooms, one with an assisted bath. There are four single bedrooms, all with wash hand basins and ceiling tracks for hoists. To the rear of the house is a large, secluded garden which is accessible to the service users, with aromatic plants and attractive features. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over several hours on 16th June 2005. There were two people using the respite unit, both of whom were out, one at college and one at a day centre. There was one other service user in the home, who was receiving day care from a separate staff team from those who work at Derriads. The management arrangements have recently changed in the home, and the acting supervisor, Ms Janine Henson is to be congratulated for the professional manner in which she conducted this inspection. What the service does well: What has improved since the last inspection? What they could do better: Staff vacancies at the home mean that agency staff are used frequently. Recruiting more permanent staff would help give a sense of consistency to service users and the staff team. The premises would further benefit from repairs to the window surrounds. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 6 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. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.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 Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.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) 1 and 2 Prospective service users have enough information to make a choice about whether they would like to stay in the home. Their needs, hopes and goals are assessed and recorded before they move in to the home for respite care so that staff know how best to support them. EVIDENCE: The home has a statement of purpose and a service user guide, which give details of the service offered, the staffing and management arrangements and the scale of fees. The management of the home has recently changed, and these documents should be amended to reflect the current situation. One service user who was due to be admitted as an emergency placement was visiting the home during the inspection. The home receives an up to date community care assessment containing considerable information from the referring community care team when a new client is planning to have respite care. Information is also kept on file for longer standing respite guests. Family members are a source of much of the information gathered, and staff visit the family wherever possible prior to respite care being offered and collect information relating to mobility, domestic skills, accessing the community, personal care needs, communication and daytime and recreational activities. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.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 and 9 Care plans reflect the needs and personal goals of respite guests, which means that staff are able to support them in the way they wish. One particular record was not kept up to date, and the home must make sure that this is done. Service users are supported to take risks where appropriate, and encouraged to be as independent as possible. EVIDENCE: Care plans were in place for all respite residents. Each service user has a support plan which is drawn up prior to their stay, and is compiled with the help of their families. These include details of any personal care needs, medical and physical health, mobility and communication skills. The support plans also highlight people’s likes and dislikes, and is entitled “All About Me”. One care plan highlighted a need for a period of extra security for one resident. This had been agreed by everyone concerned, and was written into the support plan. The times when this was needed were meant to be recorded, although there were several instances when this had not been done. This meant that it was difficult to know how long the period of extra security had gone on, or when it was finished. The home must make sure that this resident’s records are kept up to date and accurate. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 10 Risk assessments were on file for both service users, and these are reviewed annually, unless there is a need to do otherwise. These included things like transferring from a wheelchair, eating and drinking, bathing and moving and handling. Staff place great emphasis on encouraging residents to be as independent as possible, while trying to minimise any risk to their safety. There is a system of scoring risks, with some scores seen as acceptable risk taking. It is recommended that if a risk is deemed to be acceptable by staff, this is discussed with the care manager, family and GP if appropriate and a signed agreement is then placed on file. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.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 and 15 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Community facilities are used on a regular basis. Residents can have as much or as little contact with family and friends as they wish, and are encouraged and supported by staff to do so. EVIDENCE: Both respite guests were out that day, and staff ensure that those who enjoy regular daytime activities can continue to do so whilst staying at Derriads. Activities include attending clubs, college and day centres, swimming, going to church, trampoline and volleyball, crafts, basic cookery and socialising with friends. One resident was said to have a very keen interest in watching football and listening to story tapes. Another enjoyed being read to. As Derriads caters for respite care guests, most already have strong links with their families. However, staff encourage and support these links, and families can visit during the respite period if they wish. Staff also visit the families to carry out regular reviews. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 12 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 and 20 Personal care needs of residents are written in care plans so that they can receive support in the way they need and prefer. The home’s medication policies and staff good practice in administration and recording ensure that service users are safe when their medication needs are being met. EVIDENCE: All respite guests have support plans for any personal care required. The information contained in them is gathered from the initial community care assessment, the home’s own assessment and staff knowledge of the service users. People have guidelines in place which say how they like to be helped to get washed and dressed, assisted with food and helped to and from bed. The home has a policy in place for all medication, and all staff have medication training when they first start work. Staff administer medication to most service users but anyone able to look after their own medication would be supported and encouraged to do so. The medication cabinet was checked and all the drugs inside were found to be correct, and records kept of when medication was given had all been signed appropriately. Staff were aware of one service user’s allergy, and this was recorded in the care plan. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 13 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 Each service user has a copy of the home’s complaints procedure, and their daily notes and care plans showed that people’s views are listened to and acted on. Despite assurances that complaints are recorded the complaints book could not be found. The policies and procedures the home has in place, and the regular updates in staff training in Protection of Vulnerable Adults, ensure that residents are safeguarded from abuse and harm. EVIDENCE: There is a complaints procedure which outlines the steps to take if there are any complaints, and all residents get a copy of this. It also gives details of how service users and families can contact the Commission for Social Care Inspection (CSCI). A complaints book is usually kept in the office, and any complaint would be recorded there. Staff on duty said that there had been no formal complaints made, but unfortunately the complaints book couldn’t be found, and the home must make sure from now on that this is made available for inspection. One family member who was in the home was raising concerns about missing clothes, although it was clear that this was not a formal complaint. It is recommended that the home also keeps a record of any concerns or minor complaints raised and how they were dealt with. The home has copies of the “No Secrets” document, as well as the organisational policies and procedures on responding to allegations of abuse. A “Whistle Blowing” procedure is also available for all staff. All staff have annual vulnerable adults training. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 14 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, 27 and 30 Overall service users have a comfortable home, although the attractiveness of the environment is let down by the poor state of the windows. The home is clean and hygienic, although one carpet was stained. The bathroom does not provide users safety nor dignity. EVIDENCE: Derriads is an extended bungalow, with level access throughout the home, and a ramp up to the front door. Care staff look after the general household cleaning and chores. The lounge is a large, comfortable room, and has some sensory equipment in one corner. The kitchen is bright, and cheerful, with a stable type door to the kitchen, so that service users can be safe whilst staff are occupied cooking. There is a very attractive garden, suitable for wheelchair access, with a seating area under shade and a swing for guests to use. The dining room windows have old metal frames, with chipped paint and cracked window sills. Staff reported that this window suffers badly from condensation. This window must therefore be repaired or replaced. The carpet in bedroom 3 was stained, and must be cleaned. The bathroom has an overhead hoist and non-slip flooring. However, the bath is only accessible from one side, and staff have to stretch across when bathing some residents. Some service users also have to be rolled over on one side and pressed up against the wall when being bathed. This could be seen to be somewhat undignified for service users and potentially risky in terms of staff damaging their backs. The home should therefore consider the possibility of re-siting the bath. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 15 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) 34 and 35 Service users’ are supported and protected by the recruitment procedures used by Wiltshire County Council, although evidence of the same robust checks must be in place when agency staff are used. Residents’ individual and joint needs are met by staff who have had induction training and are undertaking NVQ. Use of the LDAF training means that the needs of service users with learning disabilities will be more fully understood. EVIDENCE: The staff team at Derriads also work at Meadow Lodge, another Chippenham respite service. Several people reported that covering both homes had become more problematic recently in light of the staff shortages. Staff on duty reported that they had to rely heavily on agency staff and that the home was currently recruiting for more staff. Wiltshire County Council’s employment checks include Criminal Records Bureau (CRB) checks, two written references and a medical declaration. There was no evidence available to show that all agency carers involved in providing personal care to service users have had their CRB checks. The home has therefore been asked to ensure they have written confirmation from any agency used that all staff provided by them have had CRB checks at an enhanced level. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 16 All staff have mandatory training which includes medication, manual handling, first aid, food hygiene, basic health and safety and risk assessment. Wiltshire County Council offers staff a wealth of training opportunities, and these opportunities are discussed and agreed at supervision sessions. Several people have recently started to do an NVQ and two people are doing NVQ Level 3 in Promoting Independence. Staff have also started using the Learning Disability Award Framework to assist their training, which means that the needs of service users with learning disabilities will be more fully understood. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 17 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 Service users benefit from a well run home. Their views, and those of their families, underpin the monitoring and review of care practice. The home’s policies and procedures, and the health and safety checks carried out, mean that residents’ safety and welfare are protected. EVIDENCE: Two acting managers are running the home as the registered manager has moved to another post within Wiltshire County Council. Neither of these managers were available during the inspection, and the acting supervisor, Ms Janine Henson is to be congratulated for the professional manner in which she conducted this inspection. An application to register a manager has yet to be submitted to the CSCI. All families are visited on an annual basis, and other contact is made by telephone and letter. A “Friends of Derriads” group has been set up, and a Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 18 questionnaire has been sent out to service users and families. The home should give consideration to formalising a response to the questionnaire, as currently this is not done. Staff also reported that they receive regular visits by senior managers of Wiltshire County Council, although there were no monthly reports available and these have not been sent to the CSCI on a monthly basis. The registered provider must ensure regular monthly visits to the home and must provide a copy of the report of these visits to the CSCI. All staff have had food hygiene training and food temperatures are recorded on a daily basis. Portable electrical equipment testing was done in July 2004, and a health and safety audit is conducted on an annual basis. Fire drills are done on a monthly basis, with fire instructions given to service users. Fire alarms are tested weekly and emergency lighting on a monthly basis. The fire extinguishers were serviced on March 2005, and there is a fire risk assessment in place for the building. Staff have contacted the Health Protection Agency and have received a copy of the new infection control procedures. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 19 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 3 3 x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 3 x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Derriads Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 3 x D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 20 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. 2. 3. 4. 5. Standard 6 22 24 24 34 Regulation 15 (2) (b) 17 (2) Schedule 4 23 (2) (b) 23 (2) (d) 19 (3) Schedule 2 26 Requirement The home must make sure that all residents records are kept up to date and accurate. The home must make sure that the complaints book is made available for inspection. The window in the dining room must be repaired or replaced. The carpet in bedroom 3 must be cleaned. 16/07/05 The home must have written confirmation from any agency used that all staff provided by them have had CRB checks at an enhanced level. The registered provider must ensure regular monthly visits to the home and must provide a copy of the report of these visits to the CSCI. Timescale for action 16/06/05 16/06/05 16/09/05 16/07/05 16/06/05 6. 39 16/07/05 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. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Refer to Standard 1 Good Practice Recommendations The Statement of Purpose and the Service User Guide Version 1.30 Page 21 2. 3. 4. 5. 9 22 27 39 should be amended to reflect the current management arrangements. Risk taking by service users which is deemed to be acceptable by staff should be discussed with all interested parties and a signed agreement placed on file. The home should keep a record of any concerns or minor complaints raised and record how they were dealt with. The home should consider the possibility of re-siting the bath in order to maintain the dignity of service users and the health and safety of staff. The home should give consideration to formalising a response to the questionnaire sent out to service users and families. Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 22 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB 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 Derriads D51_D01_S32436_DERRIADS_V195014_160605_Stage4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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