Inspection on 10/05/05 for Development Centre

This inspection was carried out on 10th May 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Development Centre 29/08/07

Development Centre 15/05/06

Development Centre 06/10/05

Development Centre 21/09/04

Development Centre 27/11/03

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

CARE HOME ADULTS 18-65 Development Centre Dorincourt Oaklawn Road Leatherhead Surrey KT22 0BT Lead Inspector Kenneth Dunn Unannounced 10th May 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. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Development Centre Address Oaklawn Road Leatherhead Surrey KT22 0BT 01372 841334 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) Queen Elizabeths Foundation Mr Dominic Joseph Lodge Care Home 57 Category(ies) of PD - Physical Disability (57) registration, with number of places PD(E) - Physical Disability over 65 (1) Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 3. The age/age range of the persons to be accomodated will be : 19-55 years, upto one service user may be aged OVER 65 YEARS Date of last inspection 21st September 2004 Brief Description of the Service: The Development Centre is a purpose built residential care home for younger adults. The home is set in the countryside in the outskirts of Leatherhead Surrey. It offers accommodation to 57 people with physical disabilities, in the category of younger adult. Stage two of the physical redevelopment of the buildings had been completed and was now fully commissioned. The centre is continuing with its plans for redevelopment both physically and philosophically. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was the home’s first inspection for the year 2005/2006. This was an unannounced visit, which meant that staff and residents were not aware that it was due to happen. Inspectors spent the first part of their visit in discussion with the manager, head of care, staff, checking the shared parts of the home and looking at care plans and reports. The home has been developed and improved in recent years and plans were now in place for further work to be done. This will provide still further quality accommodation for all service users. Care and health plans were found to provide a good level of information about each individual, based upon a sound assessment of their needs and aspirations. The second part of the inspection was spent with the residents, many of whom spoke openly about their day and life in the home. On more than one occasion service users expressed their feeling towards the service and the staff generally this was very positive, where there was a negative it was in respect of the physical buildings limitations and not the service offered. Individual service users comments and suggestions are contained within this report. What the service does well: What has improved since the last inspection? The training and development of staff continues to improve, with supervision being undertaken by the manager and deputy on a regular basis. The manager Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 6 and another member of staff had started to work towards their individual NVQ’s. 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. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 & 4 The home was found to be operating effectively in respect of these standards. Inspectors were impressed by the availability and quality of information about the home and felt confident that this would help prospective residents to make an informed choice as to whether the home would be a suitable place to live. The organisation and more importantly the manager and his staff are all committed to ensuring that the service users are fully briefed about their rights and these rights are clearly visible throughout all of the home documentation. EVIDENCE: The home regularly reviews and revises both its statement of purpose and service user guide to ensure that the service users are provided with the most up-to-date information about the service as possible. The inspector was able to view the most recent copy available. These have been made more user friendly and incorporate more appropriate practical information for the service users to access. There was also evidence that staff took time to explain these documents to residents, both in residents’ meetings and on a key worker basis. Sampling of care plans provided evidence that the home has established a sound process of assessing residents’ needs and aspirations and this was being enhanced by the development of person centred planning. The Inspector reviewed detailed documents for two potential service users how were undertaking an extensive assessment process to ensure that the Development Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 9 Centre could meet the needs, and that this was ultimately the most appropriate home to allow theses young adults to develop their skills. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 & 9 Evidence gathered from this inspection indicated that the individual needs and choices of the service users were being met effectively. There is a positive atmosphere at this home with the service users fully aware of the own needs and their individual choices for the future, either inside of the service or within the community. The staff were fully supportive of service users and treat every situation as unique they do not relay upon stock answers for a situation. It was very evident that events that could be seen as negative in the lives of service users were reviewed to ensure that a positive angle could be found. EVIDENCE: In discussions with the service users it was clear that they were aware of their individual care plans and that they contained information about them, their needs and wishes. Individual files and discussion with residents and staff provided evidence that residents were encouraged to be as independent and in control of their lives as possible. The manager explained that the home was trying very hard to return to its original concept of providing an environment to improve and advance with the ultimate goal for the service users to live as independent a life as possible in the greater community. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 11 It was evident that risk assessments were produced in consultation with the individual. The inspector was able to review risk assessments and they demonstrated a good awareness of the needs of the individuals concerned. The staff analyses the risks with the service users and together they agree a programme around the perceived risk, to enable the service users to still benefit from an element of the risk. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12,13 & 17 The Development Centre meets each of the assessed standards. The manager and staff demonstrated that residents were encouraged and supported to lead as independent and fulfilling life as they were able. The home has a full time activities department who have the responsibility for the development of an individual and varied programme events for each service user. The programmes are designed to meet individual needs and are largely instigated by the service users themselves. Links with the families, friends and the local community are very good. EVIDENCE: The relationship between the service users, staff and the managers was observed to be relaxed and friendly, creating a warm and homely feel. The service users were encouraged and supported to be as independent as they were able. There was good evidence of the busy and interesting lives the service users have, one service users had successfully completed a second screen test to develop her acting abilities and a future career. The service users spoke positively about the help and assistance the staff had given her in achieving this goal. Service users lead as independent a life as possible service users regularly travel outside the centre to meet friends and to take part in events such as acting at the local theatre, shopping and holidays. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 13 Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 &19 The manager and the staff group were able to demonstrate that they have a good understanding of the residents support needs. This was evident from the positive interactions and relationships observed by the inspector while touring the home. The Development Centre is clearly able to appropriately cater for the residents’ health and personal care needs, there was clear evidence that they were being appropriately met. EVIDENCE: All service users have their own individualised care plans. The care plans are comprehensive with regard to the service users individual care needs. Discussions with the staff and direct observation during the inspection suggested that all care needs were being fully met. The Inspector reviewed comprehensive assessment document clearly demonstrating that individual needs were being met. There was clear guidance for all aspects of the care to be provided with good emphasis being placed upon the individual wishes of the service users. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Evidence gathered during this inspection confirmed that the home meets each of the assessed standards. This home was able to demonstrate that service users were being appropriately protected and that their rights, views and comments were important and acted upon. EVIDENCE: During the inspection all of the service users, who spoke to the inspectors, knew how to and who they could talk to if they had a problem or were worried about anything. The inspector was told by service users that they felt that staff were always willing to listen to them and help in any way that they could. This was confirmed by the observed interactions between residents and staff. During the inspectors tour of the building one service user was very vocal about an issue, which he wanted to complain about and to be include in this report (see requirements No1 page 20). This issues is discussed in the environment section of this report. The registered persons stated that all staff have completed vulnerable adults protection procedures training and were thereby aware of the action to take should they have a concern or if an allegation of abuse was made. In addition to the in-house complaints procedure the service users have access to the complaints guidelines from the Independent Housing Ombudsman’s. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27, 28, 29 & 30 The Development Centre is a large purpose built home and by its nature could not be described as homely, however every effort has been made to ensure that it is comfortable and offers a safe environment for the service users. The service provides a good level of accommodation appropriate to the needs of the current residents. There were several areas of concern where the manager must ensure that action is taken immediately. EVIDENCE: The home has been developed and improved in recent years and plans were in place for further work to be done stage 3 of the redevelopment programme. This will complete the programme of redevelopment and offer all the service users the same high level of living accommodation. Shared space will also be improved. It was a requirement that the manager provides the CSCI with an action plan giving details of how the work will be completed and contingencies that are planned to ensure the effect of the work on service users is minimised. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 17 As was previously stated in the section above one service user complained about the inability to access one of the new communal areas. He felt that the doors should be on the same automatic swipe card system as the rest of the area to allow the service users to have free and easy access to a room that they all use. The Inspector had to assist another service user into the same area when he first arrived on the premises and again the service users complained about his difficulties in gaining access without always having to ask someone, which he found frustrating. In some areas of the building radiators have had to be taken off of the walls due to a failure in the system as a result fixing brackets are now accessible and containers have had to be positioned to collect water from other radiators left on the wall, as a result there is a potential risk to service users as they navigate down the corridors. Throughout the home the cleanliness and hygiene controls are evident and work appropriately. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 & 36 Staff appeared to be enthusiastic and committed to supporting service users, with training and development given a high priority. Staff in the home have a good understanding of the needs of the Service Users and are appropriately supported by the manager on a regular formal and informal basis. EVIDENCE: The relationship between the service users, staff and managers was observed to be relaxed and friendly, creating a warm and homely feel. The service users were encouraged and supported to be as independent as they were able this was supported by very comprehensive individual care and activity plans. The service users who spoke to the inspector during the inspection were complimentary about the staff and were unaware of any issues within the home. They felt very supported by everyone at the Development Centre. The manager stated that training and development of staff had been given a high priority and that the service had over 50 of its current staff group trained to NVQ level 2 or above. All staff receive regular supervision both formally on average every 6 to 8 weeks in addition the manager of the service encourages an open door policy allowing any member of staff the right to informally chat over issues they may have. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 19 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) 38, 39, 40, 42 & 43. There is good leadership in the Development Centre this comes from the registered manager (Centre Principal) and his departmental managers. There is a consistent and appropriate directions offered to staff to ensure that the Service Users receive consistent quality care. The managers are all fully aware of the needs of the Service Users in the home and they are able to successfully communicate this to staff through regular staff meetings and individual supervision sessions. EVIDENCE: The frequency of staff meetings, formal and informal supervision was indicative of an open and supportive atmosphere at the home. There were policies and procedures in place for the health, safety and welfare of service users and staff these were seen and in good order. Detailed policies and procedures were in place in relation to safe working practices and again there was sufficient evidence to indicate that they were being fully adhered to. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 20 Throughout the inspection the manager was greeted warmly by service users and they appeared to genuinely enjoy his company. The manager for his part was able to demonstrate a good knowledge of the service users not just about their individual care needs but more importantly what they aspired to and where they wanted to go with their lives. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 21 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 2 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 2 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Development Centre Dorincourt Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 3 3 x 3 3 H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA28 Regulation 16(1) 23(2) 16(1) 23(2) Requirement Timescale for action Immediate 2. YA28 3. YA24 13(4) 16(1) 23(1) The manager must ensure that the heating system is repaired and all radiators are returned to there correct position. The service users must have Immediate access to all communal areas. The manager must ensre that the automatic doors are fitted to these doors. It was a requirement that an 3 months – action plan must be provided 05/07/05 giving details of how the work will be completed and contingencies that are planned to ensure the effect of the work on service users is minimised. There have been concerns about the uneven flagstone patio to the rear of the premises; proposals for these must be included in the action plan. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 23 Development Centre Dorincourt 1. Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Development Centre Dorincourt H58 s13626 Development Centre v227336 100505 stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!