Inspection on 06/10/05 for Development Centre

This inspection was carried out on 6th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 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 10/05/05

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 Dorincourt Oaklawn Road Leatherhead Surrey KT22 0BT Lead Inspector Kenneth Dunn Unannounced Inspection 6th October 2005 10:00 Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 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 Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 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. Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Development Centre Dorincourt Address Dorincourt Oaklawn Road Leatherhead Surrey KT22 0BT 01372 841334 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) dominic.lodge@developmentcentre.org Queen Elizabeth`s Foundation Mr Dominic Joseph Lodge Care Home 57 Category(ies) of Physical disability (57), Physical disability over registration, with number 65 years of age (1) of places Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 19-55 YEARS, up to one Service User may be aged OVER 65 YEARS 10th May 2005 Date of last inspection Brief Description of the Service: The Development Centre is a purpose built residential care home set the countryside in the outskirts of Leatherhead Surrey. It offers accommodation to 57 people with physical disabilities, in the category of younger adult. The service has recently undergone a process of redevelopment of some of the buildings. The centre is continuing with its plans for redevelopment both physically and philosophically. Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was the home’s second inspection for the year 2005/2006. This was an unannounced visit, which meant that staff and residents were unaware that it was due to happen. Inspectors spent the first part of their visit in discussion with the manager and 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. 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 showed the inspectors their rooms and spoke about their day and life in the home. The home provided a high level of individualised support to service users. This was a commendable part of the home’s operation. Links with service users friends and family were well developed and maintained by the operation of the home. Service users’ health needs were well met. The home has a robust complaints procedure. There have been no complaints received either by the service or by the CSCI in relation to this service. The home is relatively well maintained but is furnished to good standard. What the service does well: What has improved since the last inspection? What they could do better: The service would benefit from listening to the service users and to act upon their wishes and complaints. The manager needs to develop an action plan for the final redevelopment of the Meadway and JAC corridors. Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 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. Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 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 Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 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 the following standard(s): 5 The service users benefit from clear and user-friendly contracts that fully outline the organisations position and the service users own obligations. EVIDENCE: The inspector reviewed the services copies held on the individual service uses files. The agreements were fully signed and dated by the service users and or their representative. In discussions with service users during the inspection they all understood that they had a contract with the home and retained a copy of it in their bedrooms. One service users explained that it had been fully discussed with her and her family and although she could not remember all of it she did understand her rights. Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 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 the following standard(s): 7, 9 & 10 The service is has attempted to ensure that the service users are assisted to make decisions and develop independent life’s inside and outside of the home. All staff understands their role in sensitively handling and storing information. EVIDENCE: Service User has been realistically involved in the development, of there care plans. These care plans clearly identified the Service Users wishes and expectations and the Service Users likes and dislikes. Evidence was found that Service Users are involved in day-to-day participation in the running of the home and are afforded the opportunity to be involved in activities. Daily diary notes and discussion with service users and staff provided evidence that they were encouraged to be as independent and in control of their lives as possible. It was evident that risk assessments were produced in consultation with the individual, as far as possible, and any restrictions were only applied where the level of risk was considered unacceptable. However it is essential that the daily notes offer a true and accurate picture of the service user and reframe from making assumptions and recording hurtful remarks or comments. The inspector reviewed one set of notes and was surprised by the unprofessional way they had been completed by the key worker, please refer to pages 13 & 14 of this report. Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 Page 10 Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 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 the following standard(s): 14, 15 & 16 Activity programmes appeared to offer varied opportunities and on the whole are designed to meet individual need. Links with the families, friends and the local community are good. EVIDENCE: Documentation indicates that all Service Users have full and varied activity programmes designed specifically for them. Comments from service users confirmed that on the whole they did enjoy both internal and external leisure activities. However this has not always been the case and one service user stated on more than one occasion she has been unable to access her activities because of a lack of staff and specifically drivers. The manager explained that there has been a change within the staff team and that they were actively recruiting staff specifically drivers in an effort to address this situation. Examination of the home’s records confirmed a high degree of personal empowerment and choices in services users daily lives. They were encouraged and supported in the use of community amenities and in maintaining relationships with friends and families. Service users attend various day centre and adult education activities. The activities programme was individualised in accordance with service users wishes and made appropriate use of college courses, community amenities and facilities. Service users had access to a Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 Page 12 range of appropriate leisure opportunities in accordance with individual preferences. They were encouraged to pursue individual interests and hobbies. Staff attempt to maintain links with Service Users’ families. Any visitors could be entertained either in the service user’s own room or in the garden. Friends are invited to visit. The home has maintained some good family links. There are no restrictions in terms of visiting times. There was evidence in the care plans that service users are supported to be as independent as possible, and are free to make decisions where possible. The service users were free to move around the home consistent with individual risk assessments in place. Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 Service Users healthcare needs were seen to be appropriately met by the systems that were in place. EVIDENCE: Bathrooms and toilets were fitted with locks for privacy. All service users are registered with the local GP and have access to all NHS healthcare facilities as required. Service users will receive support from members of staff e.g. offering support to and from appointments. There is a good medication policy in place. The home has a key work system in place. Key workers are responsible for ensuring that service users receive personal support in a way they prefer and/or require and this is documented in the care plans. However there is a need to ensure that key workers and service users can work effectively as part of a team. One service user informed the inspector that she had complained about her key worker to the manager and felt that there was no relationship between them to work with. The service user was upset because she felt that the manager had not taken heed of her complaints as she is still supported by the same key worker. The service users stated that she needed to have positive support when she is receiving assistance in her care and this has not always been there. The daily notes the key worker has written about this specific service user supported the concerns raised by her. The language the key worker used when completing daily care notes was very negative and emotive and even if it was not designed to offend it caused considerable offence to the service users and her family. Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 Page 14 Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 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 the following standard(s): 22 & 23 The home has a satisfactory complaints system that is made available to all Service Users and staff. EVIDENCE: The organisation had its own adult protection policy and procedure and a copy of Surrey’s multi-agency vulnerable adult abuse procedure was available in the home. The subject of abuse was addressed within the staff induction programme. Up to date training in the Protection of Vulnerable Adults will be talking place during April 2005. The complaint procedure was compliant with statutory requirements. Complaint forms were available for recording complaints. Records demonstrated there had been no formal complaint received by the home or the regulator within the last twelve months. However as was previously stated in the section above there have been complaints made by at least one service users and her family and these have not been recorded or successfully dealt with. Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 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 the following standard(s): 24, 27 & 28 Evidence gathered during this inspection confirmed that, the redevelopment of the home has improved the general environment of the home. However there are several areas where the home does not meet the needs of the service users. EVIDENCE: The home has been developed and improved in recent years and plans were in place for further work to be done. This will provide improved bedrooms and bathroom facilities in the two remaining un-renovated bedroom corridors (Meadway and JAC). The current bathrooms in both corridors are substandard and in desperate need of total updating to meet the most basic needs of the service users. The bathrooms in both corridors are old, very stark and extremely institutional. The overall design of the bathrooms offers little or no privacy for anyone using the facilities. In addition the inspector found storage cupboards in the same two areas containing inappropriate items including old paint tins, suitcases, old bedding and continence aids. The manger must ensure that all areas of the home are kept clean and hygienic. The laundry areas within the Woodside flats was found to be dirty and the floor had split detergent powder left on it. The inspector was informed that the laundry has been cleaned in the past by visiting family members of service users. The inspector was very disappointed to note that an immediate requirement from the previous inspection report had not been completed, and the doors Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 Page 17 into the main recreation room still impeded the access of the service users. The same service user who raised the issue previously again highlighted this to the inspector and the manager. It is therefore a requirement of this inspection that an action plan must be provided giving details of how and when 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 DS0000013626.V253613.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 & 33 Staff in the home have on the whole a good understanding of the needs of the Service Users and every effort is taken to ensure the staff work effectively with each individual. EVIDENCE: The relationship between service users and staff was observed to be relaxed and friendly, creating a warm and homely feel. The manager claimed that service users were encouraged and supported to be as independent as they were able. Feed back from several service users confirmed that in general the environment of the home was relaxed and they have the support they need to allow them to be independent. It is necessary for the service to stay effective and to achieve this, the manager must listen to concerns of both the service users and the staff. The manager must then ensure that once any concerns are raised they should be acted upon. A family member of a service users stated, “there will always be the potential for some form of personality conflict this is only human nature, however it is important that when these conflicts are highlighted something must be done before a full and final breakdown occurs”. The responsibility for ensuring that the service operates to maximise everyone’s potential it that of the manager and he must ensure that all the staff employed at the service fully understands the needs of the service and acts upon issues and complaints made by service users as they are raised. Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 41 & 42 The service has recently appointed a new manager who has still to apply to the CSCi for his registration. The home has clear Policies and Procedures and the health, safety and welfare of residents are promoted and protected. EVIDENCE: The manager had a very open approach. From observation of the manager’s interactions with service users it was clear that there was an atmosphere of openness and respect, in which the service users felt valued. Service users stated that staff look after them well and are concerned about their safety. Staff have completed environmental risk assessments these were observed by both the service users and staff. Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X 3 Standard No 22 23 Score 1 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 2 X 3 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 1 X X 1 2 X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 2 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score 3 2 2 X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Development Centre Dorincourt Score 2 1 3 3 Standard No 37 38 39 40 41 42 43 Score X X X X 2 3 X DS0000013626.V253613.R01.S.doc Version 5.0 Page 21 YES 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 YA7 Regulation 12(2 & 3) Requirement The Service Users must be supported and assisted to fully participate in the home and to be supported appropriately to become as independent as possible. The manager must ensure that all staff are fully trained in effective and appropriate record keeping. The service users must not be restricted from accessing their chosen leisure activities because of a lack of trained staff. The manager must ensure that all staff receive training in respect and dignity. The manager must ensure that issues raised by service users are acted upon appropriately and within a structured time frame work. The manager must complete a full review of the suitability and usability of the bathroom facilities within Meadway and JAC corridors. The manager must make an application to the CSCI to become the registered manager DS0000013626.V253613.R01.S.doc Timescale for action 06/11/05 2 YA12, 32 & 41 YA14, 32 16(2)(m) 18(1)(a,c) 17 16(2)(m) 18(1)(a,c) 12(1-4) 13(1) 18(1,3) 22(1,3,4) 06/11/05 3 06/11/05 4 5 YA16, 18, 19 YA22 06/11/05 06/11/05 6 YA24, 27 16(1) 23(1,2)(j) 06/11/05 7 YA38 10(1) 12(2,3,5) 06/10/05 Development Centre Dorincourt Version 5.0 Page 22 of the service. 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 Development Centre Dorincourt DS0000013626.V253613.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Surrey Area Office 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 DS0000013626.V253613.R01.S.doc Version 5.0 Page 24 - 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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