Inspection on 01/06/07 for Derwent House

This inspection was carried out on 1st June 2007.

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

Derwent House 13/12/06

Derwent House 17/02/06

Derwent House 29/03/05

Derwent House 03/08/04

Derwent House 14/01/04

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

CARE HOME ADULTS 18-65 Derwent House 206/8 Lightwood Road Longton Stoke-on-Trent Staffordshire ST3 4JZ Lead Inspector Dawn Dillion Key Unannounced Inspection 1st June 2007 11:00 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 Derwent House DS0000008222.V342227.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. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Derwent House Address 206/8 Lightwood Road Longton Stoke-on-Trent Staffordshire ST3 4JZ 01782 599844 01782 318281 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) Mr Alan John Bradshaw Mrs J Bradshaw Mrs Joy Bradshaw Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 2006 Brief Description of the Service: Derwent House is a registered Care Home that provides a service for fourteen adults of both genders who have a learning disability. The home is located in Stoke On Trent, Staffordshire and is accessible via public transport and close to local amenities. The property consists of two large mature semi-detached houses. The exterior of the properties remain as two houses, in keeping with the local community. The interior structure had been designed to allow access through both buildings on two floors. The home provides ten single occupancy and two shared bedrooms, of which are located over the three floors. There is no passenger lift or specialist aids or adaptations available and these are not currently required for the people living in the home. Three bedrooms are equipped with an en suite, with the remaining bedrooms having a washbasin. Two toilets are located on the ground floor, one bathroom and a shower room is situated on the first floor. The property also provides a dinning area, a separate lounge, two kitchens and a small laundry. People who live at the home have access to two gardens located at the rear of the property. Limited parking is available at the front of the building. Staffing is provided on a twenty-four basis to support individuals to live a socially inclusive lifestyle and develop necessary skills for independent living. Following assessment of risk, individuals are able to access community services and facilities independently and take the lead role in their care. The fees chargeable for the service provided at Derwent House is from £325.00p to £335.00p Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced Key Inspection of Derwent House was undertaken in 5 hours. The inspection methodologies that were used to establish the quality of care provided and the effectiveness of the management of the home, to promote quality, diversity and best practices entailed the examination of records relating the homes policies and procedures. Three people using the service were interviewed to ascertain their views and opinions of the service provided and the level of support and guidance offered, to ensure that they were able to live a lifestyle, of their choice with regards to their cultural and identified care needs. A tour of the property was also undertaken to ensure that the environment and systems in operation were safe and conducive in meeting the needs of the people living at the home. The Registered Manager was present during the process of the inspection. The home provided a good standard of care. What the service does well: There was a positive emphasis focused on promoting the individuals independence and enabling people to participate in the running of the home. The necessary support and encouragement was provided, to ensure that people using the service had access to meaningful social activities and employment. People were also able to access the local college to learn new skills and to have a positive presence within their community. One person expressed her appreciation of the support provided to her by the staff in helping her find her family. Staff communicated and interacting with people who use the service in a positive and professional manner. The homes practices promoted people’s rights and choice enabling them to make informed decisions in areas affecting their lifestyle and general welfare. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. 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 Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The examination of the homes Statement of Purpose and the Service User Guide. People who wish to access the service at Derwent House were provided with sufficient information, to enable them to make an informed choice to whether the service would meet their needs. EVIDENCE: The homes Statement of Purpose provided comprehensive information relating to the service and provisions available within the home. People using the service were also in receipt of a service user guide, which provided additional information, relating to the service available at the home. Discussions with the Registered Manager confirmed that they have not had any new admissions within the year. People were admitted to the home on the basis of a full assessment. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 10 The homes admission procedure enabled the individual to visit the home prior to the offer of a placement, and also where appropriate they were able to have an overnight stay. The admission process was conducted at a pace suitable to the individual. The examination of the care plans and discussions with people who lived at the home, confirmed that they had access to relevant specialist services. One person using the service informed the Inspector that, “I have a Continence Nurse, who comes to see me, to see if I’m ok.” “I go to the doctors when I need to go, like if I’m not well.” Discussions with the Registered Manager confirmed that there was no one living in the home that had any specific cultural or religious needs. The homes Statement of Purpose stated, “We aim to demonstrate that we welcome and celebrate the diversity of people in our community and in this home.” The Registered Manager was confident that the home would be able to offer a service for individuals from the ethnic minority group. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 11 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, 8 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The examination of care plans, risk assessments, minutes of meetings and discussions with people that use the service. People using the service were actively involved in decisions relating to their lifestyle, their care and the support they receive. EVIDENCE: People using the service at Derwent House were provided with the necessary support to enable them to make major life decisions as well as everyday choices. Care plans were in place for each person, three care plans were randomly selected for examination, all of which evidenced that the person using the service, was actively involved in the development and review of their care Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 12 plan. The care plans were reviewed on a regular basis to reflect the changing needs of the individual. People using the service had access to relevant healthcare services to meet their physical and mental health needs. The Registered Manager informed the Inspector that meetings were undertaken with the people that live at the home, giving them the opportunity to keep abreast of any changes to the service delivery and forthcoming social events and also to express their views and opinion in relation to the running of the home. There was a positive emphasis focused on social inclusion, and support provided to ensure that individuals participated in the management of the home. Three risk assessments were examined of which, provided information relating to potential hazards and also included information about the appropriate control measures to reduce or eliminate the identified risk, this enabled people to take a responsible risk to promote normal daily living. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 13 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 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Discussions with people that use the service and general observations. People using the service were provided with the necessary support and guidance to be involved in social activities within and outside the home and to have a positive presence within their local community. EVIDENCE: The routines and practices within the home promoted people’s independence, rights and choice and also enabled them to have a positive presence within their local community. The majority of people living in the home were able to access facilities within the community independently. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 14 Discussions with people who use the service, confirmed that they were involved in various activities of their choice. A number of people attended the local colleges undertaking courses to enhance their daily living skills. Some people also had work placements; the Registered Manager informed the Inspector that a couple of people who live at the home were employed at the local supermarket until its recent closure. People using the service were also able to continue to practice their religious faith and were able to attend a place of worship if they so wished. Discussions with people living in the home and the Registered Manager identified forthcoming plans for annual holidays. Two people informed the Inspector that they were going to Spain in a few days. Holidays consisted of visits to Wales, France, Devon and two people were going on a cruise with their parents. The Registered Manager confirmed that people using the service funded their own holiday and the home paid for the staffing. People using the service were provided with the necessary support to enable them to maintain contact with their family and friends. One person informed the Inspector that the staff assisted her in finding her family, she said, “ I don’t know what I would have done without their help.” Bedrooms doors were fitted with a locking device to promote the privacy of the individual. One person informed the Inspector that, “I have got a key to my bedroom so I have some privacy.” One person using the service informed the Inspector of her work and college placement, and showed the Inspector her certificate on achieving her Basic Food Hygiene award, she said, “I can’t believe I passed but I did.” Menus were designed to reflect the likes and dislikes of people using the service, the individual were actively involved in developing the menus and assisting with preparation and cooking of meals. The Registered Manager confirmed that there were no special dietary requirements due to cultural or religious needs. One person suffering with diabetes received regular input from a ‘Diabetic Nurse,’ with regards to her dietary needs. A dietician was also involved with one person to promote healthy eating. One person informed the Inspector that, “the meals are very nice, I do cook but not all the time.” Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 15 Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 16 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 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The examination of care plans, risk assessments and discussions with people who use the service. People using the service received effective personal and healthcare support in accordance to their assessed needs. EVIDENCE: The examination of care plans and discussions with people who live at the home, confirmed that they had access to healthcare services for routine health screening. Three care plans were randomly selected for examination, one person diagnosed with having diabetes had regular access to a ‘Diabetic Nurse,’ a diabetic care plan was also in place. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 17 One person was receiving support from a dietician to promote healthy eating and to assist the individual in losing weight. Another person living in the home received regular input from the Community Nurse to monitor their epilepsy. The Registered Manager informed the Inspector that the Community Nurse provided an effective health screening service. One person using the service said, “I go to the opticians to have my eyes tested and sometimes I go to the dentist to have my teeth checked.” The home operated the Nomad Monitored Dosage system; there were no controlled drugs in use. One person was prescribed PRN (when required) medication; a protocol for the use of this medication was in place. The examination of the administration records, cassettes and the homes practices confirmed that the medication system was robust in ensuing that people received their medication as directed by the General Practitioner. Discussions with the Registered Manager confirmed that Derwent House was a home for life and every effort would be made to accommodate the individuals changing needs. However, the home would not be able to provide a service for anyone requiring regular nursing intervention. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 18 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The examination of the homes complaint procedure and files pertaining to staff. People who lived in the home were able to express their concerns, and had access to the complaints procedure. The homes recruitment process ensured that people were protected from abuse. EVIDENCE: There was a complaint procedure in place of which was accessible to all persons living in the home. One person informed the Inspector that, “We go to the staff if we have any complaints, they try to help us sort it out.” The examination of records identified that all complaints were recorded and provided information relating to what actions were taken to address the concern. The Registered Manager informed the Inspector that one staff had been recruited since the last inspection visit. The examination of records relating to the homes recruitment process evidenced that the appropriate safety checks were undertaken prior to the offer of employment. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 19 The Registered Manager confirmed that staff had received Protection of Vulnerable Adult (Safeguarding) training in January 2007 and that this training was on going. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 20 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A tour of the premises and the examination of records relating to safety checks. The design and layout of the home was safe and conducive in meeting the needs of the people using the service. EVIDENCE: Derwent House is located in Stoke On Trent, Staffordshire and is accessible via public transport and close to local amenities. The property consisted of two large mature semi-detached houses. The exterior of the properties remain as two houses, in keeping with the local community. The interior structure had been designed to allow access through both buildings on two floors. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 21 The home provided ten single occupancy and two shared bedrooms, of which were located over the three floors. There were no passenger lift or specialist aids or adaptations available and these were not currently required for the people living in the home. A number of bedrooms had recently been decorated and discussions with people living in the home confirmed that they were actively involved in choosing the colour scheme. Three bedrooms were equipped with an en suite, with the remaining bedrooms having a washbasin. Two toilets were located on the ground floor, one bathroom and a shower room was situated on the first floor. The property also provided a dinning area, a separate lounge, two kitchens and a small laundry. People using the service had access to two gardens located at the rear of the property. Limited parking was available at the front of the building. The cleanliness of the home was if a good standard. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 22 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, 34 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The examination of staff files and training records. The home was proactive in providing staff training, to ensure that people who use the service were provided with a good standard of care in relation to their assessed needs. EVIDENCE: The Registered Manager informed the Inspector that twenty staff members were in place to meet the needs of fourteen people. Two care staff were provided during the morning and evening, having one wakeful staff and one person undertaking sleep-in duties during the night. Fourteen out of twenty staff had obtained the National Vocational qualification level 2 or 3 in care and promoting independence. The examination of training records and certificates evidenced that staff had received relevant training in relation to their roles and responsibilities. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 23 The Registered Manager confirmed that one member of staff had been recruited since the last inspection visit. The examination of staff files evidenced that staff were subject to the appropriate safety checks prior to the commencement of employment. The home operated a comprehensive induction for new staff, the examination of the induction portfolio evidenced that all new staff were provided with the appropriate support. Information contained within staff files evidenced that staff received regular supervision and support required to do their jobs effectively. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 24 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Discussions with people who use the service, the examination of the homes policies and procedures in relation to the running of the home. The management of the home was open, transparent and promoted the independence and general welfare of people using the service. EVIDENCE: The Registered Manager was experienced and undertook periodical training to keep abreast of issues relating learning disability services and social care. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 25 With reference to the homes quality assurance systems, questionnaires were distributed to people who use the service; the information collated was fed back during routine meetings. There was very little evidence of any other systems in operation to monitor the quality of the service delivery in the home. Safety records with regards to the building and appliances in use evidenced that the appropriate safety checks and servicing took place at regular intervals, to ensure the safety of all people accessing the service at Derwent House. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 26 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 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 X LIFESTYLES Standard No Score 11 3 12 4 13 4 14 4 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 X X 3 X Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 27 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. Standard Regulation 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 YA39 Good Practice Recommendations The home needs to have an effective quality assurance system in place, to monitor the quality of the service delivery, in accordance to the Statement of Purpose. Derwent House DS0000008222.V342227.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor, Ladywood House 45-56 Stephenson Street Birmingham B2 4UZ 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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