CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE
Don View 22 Thellusson Avenue Scawsby Doncaster South Yorkshire DN5 8QN Lead Inspector
Ian Hall Unannounced Inspection 1st November 2005 08.45 X10029.doc Version 1.40 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 Don View DS0000031838.V259688.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 Older People and 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. Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Don View Address 22 Thellusson Avenue Scawsby Doncaster South Yorkshire DN5 8QN 01302 785257 01302 789457 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) Doncaster Metropolitan Borough Council Gareth Anthony Bishop Care Home 25 Category(ies) of Learning disability (25) registration, with number of places Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The support of a day care centre must not impact on the staffing needs of Don View. There must be no removal of staff from the home`s rota to meet a shortfall in the day centre staffing or to meet needs of the persons who reside in the independent living house. Wheelchair dependent service users must be allocated private accommodation that has 12 square metres of useable floor space. The home is registered to admit service users over the age of 50 years. 2. 3. Date of last inspection 24th August 2005 Brief Description of the Service: Don View is a care home that provides personal care for up to 25 persons who are aged over 50 years with a learning disability. The majority of residents are aged between 50 and 65 years the remainder are aged over 65 years. The home is owned by Doncaster Metropolitan Council. It is located in the small community of Scawsby which is approximately 4 miles from Doncaster. It is easily accessed from the A1M with frequent bus services stopping a short distance from the home. Adequate carparking spaces are available with unlimited on street parking within the quiet residential area. The home is well integrated into the local community. The home was built in the late sixties with change of purpose to its current registration over 20 years ago. It is a three storey building with staircases to all floors. There is lift access from ground to the first floor. The second floor is accessed by means of a short staircase. All residents are accomodated in single bedrooms. Toilets and bathrooms are readily accessible on each floor. The dining area is located on the ground floor adjacent to the kitchen. There are several lounge areas located on both the ground and first floor, their useage is varied and distinct : TV/music lounge, quiet lounge and smoking lounge. Each floor has level access throughout with handrails and wide corridors. The home is set within its own grounds and well maintained gardens. There is a large sheltered easily accessible patio/barbecue area that is popular with residents. Unregistered day-care and sheltered housing is provided within the curtilage of the home. Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over six and a half hours and was the first of the cycle of inspections for the year 2005/6 and followed a risk assessment carried out with the CSCI risk assessment tool. The focus of the inspection was to meet the residents, visitors and the staff team to obtain the residents views of life at the home. Four residents care documents/files were “case tracked” along with any associated records that were maintained. The Inspector toured the home with the Senior Officer in Charge to monitor the works and changes that the Local Authority had undertaken since the last inspection. What the service does well: What has improved since the last inspection? What they could do better:
Mr Bishop the home manager confirmed the Authority’s plans to continue with the redecoration and refurbishment of Don View. Access to the Day-unit is via Don View the Authority has submitted an action plan to provide alternative access. This work is to commence shortly. Don View DS0000031838.V259688.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. Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6. Discussion with management demonstrated that they clearly consider the needs of existing service users when they assess potential residents needs to ensure that all can live amicably together. Service users and their advocates are involved in choosing to live at Don View. EVIDENCE: Case records examined contained copies of comprehensive individual care needs assessment, care plans and written contracts stating terms and conditions of residence and service/ care to be provided. Service users confirmed that they had visited the home and spent time there before finally deciding to live at Don View. Intermediate Care is not provided at Don View. Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service Users, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Service users (and their advocates) had been involved in the compilation of their care plan. These reflected individual choice and any help required. Minutes from service user meetings were available and provided evidence of consultation and involvement in decision making at Don View. Care plans contained additional lifestyle risk assessments. EVIDENCE: Four service users case files and associated records were inspected. Each contained “individual” needs and risk assessments. These reflected a whole range of activities and care needs; including input from a District Nurse to
Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 10 maintain and improve physical health and assessing the risk for an individual to travel to town, spend a prolonged period alone and return safely at the end of the day. These had been discussed with the individual concerned and their thoughts, wishes and decision incorporated into the care plans. The records were detailed and maintained correctly. Changes to plans and reassessments for physical, social and psychological needs were ongoing ensuring that the correct level of care is provided. Several service users were facilitated to self-medicate to maximise their independence. Staff had received additional accredited medication training for the administration and management of medicines to ensure safe practises are followed. Staff was observed dispensing medications and enabling/assisting residents to take them in line with safe practice. Service users confirmed that they were happy living at the home and that staff were “good to them”. Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service Users have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Service users are encouraged and enabled to exercise choice within their lives. The Manager and his team provide a homely, welcoming, stimulating and inclusive atmosphere for all service users of Don View. There are strong links and involvement with the immediate and wider community. EVIDENCE: Service users confirmed their satisfaction with the support and encouragement they receive from the staff. Discussions with service users and staff and examination of case files demonstrated that individuals are able and encouraged to pursue their personal hobbies and interests. Many of the service users attended their “work” or “educational” placements throughout the day.
Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 12 They utilise one of the many Local Authority minibuses provided to enable them to attend their placements. Service users visit local shops and facilities with a number of them visiting Doncaster in line with a daily living pattern. Some require assistance whilst others are self-sufficient. Service users had chosen from a variety of destinations an annual holiday they had all enjoyed. A number of service users are able to enjoy the company of family and friends and spend time away from the home with them. Visiting is “open” and encouraged at any reasonable time. Service users confirmed their satisfaction and enjoyment of food provided. There was a choice from the menu for breakfast and midday meal. Special diets were available for residents requiring this service. Staff sought the dietician’s advice as service users needed advice or assistance. Drinks and snacks were available throughout the 24-hour period. Staff assisted service users with diets as required. The midday meal both smelled and appeared appetising. Additional or larger portions were available for service users with a larger appetite. Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service Users feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Service users are encouraged and enabled to exercise choice within their lives. The Manager and his team provide a homely, welcoming, stimulating and inclusive atmosphere for all residents of Don View. There are strong links and involvement with the immediate and wider community. EVIDENCE: Service users confirmed their satisfaction with the support and encouragement they receive from the staff. Discussions with service users and staff and examination of case files demonstrated that individuals are able and encouraged to pursue their personal hobbies and interests. Many of the residents attended their “work” or “educational” placements throughout the day. They utilise one of the many Local Authority minibuses provided to enable them to attend their placements. Service users visit local shops and facilities with a number of them visiting Doncaster in line with a daily living pattern. Some require assistance whilst others are self-sufficient. Service users had chosen from a variety of destinations an annual holiday they had all enjoyed. Some service users are able to enjoy the company of family and friends and spend time away from the home with them. Visiting is “open” and encouraged at any reasonable time. Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 14 Service users had a choice from the menu for breakfast and midday meal. Special diets were available for residents requiring this service. Staff sought the dietician’s advice as service users needed advice or assistance. Drinks and snacks were available throughout the 24-hour period. Staff assisted service users with diets as required. The midday meal both smelled and appeared appetising. Additional or larger portions were available for residents with a larger appetite. Service users confirmed their satisfaction and enjoyment of food provided. Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 15 Environment
The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. Don View both appeared clean and smelled fresh. Mr Bishop and his staff team work hard to maintain and improve the service users environment. EVIDENCE: The home was clean and fresh. Service users and staff were pleased with the substantial works that have been undertaken to improve the environment and safety at Don View. They were very complimentary when describing the ongoing redecoration and refurbishment of the home. Service users whose rooms had been redecorated and re-carpeted had been offered a choice of
Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 16 décor/colours. The Inspector entered a number of bedrooms; the occupants had taken the opportunity to personalise their own rooms with items of furniture and memorabilia. New armchairs, TV’s, re-carpeting wallpapering and painting had continued since the last inspection. Replacement of windows was complete; windows were restricted in opening distance with radiators being protected by stylish covers to reduce risk to residents. Redecoration of toilets/bathrooms had commenced with curtains and details to finish and soften the environment being provided. One bathing facility is being replaced to meet an individual service user needs following a risk assessment. Toilets and bathrooms are equipped with suitable safety aids. The services of an Occupational Therapist are utilised to assist with assessment of need. Within lounges and communal areas upgrading and redecoration had commenced. New armchairs, TV’s, set-top box and carpets have been provided. There was a number of lounges ensuring choice is provided; i.e. quiet areas, music/TV areas, and smoke-room. This work is ongoing in accordance with the overall improvements required from the last inspection. Don View management team is responsible for the Day Care Service that shares the site. It currently impacts upon the quality of daily life and care provided at Don View. The Day Care Service Users access via Don View and toilet/ bathing facilities has been reviewed with an action plan implemented to improve service user quality of life. Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 17 Staffing
The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Staff was well motivated and positive; deriving personal satisfaction from their work. Induction and ongoing training and assessment was encouraged and facilitated to maintain competent and skilled workforce. EVIDENCE: Staff are well motivated and enthusiastic about their work. They were observed to interact appropriately with the service users, encouraging, assisting as needed and displaying empathy for the individual. Visitors to the home were greeted appropriately and pleasantly, they commented that the staff were always most helpful. Following a DMBC policy change the recruitment process has been slowed considerably, several care and ancillary positions have remained vacant for a prolonged period. The Manager has been well supported by his line manager Mr Pickersgill to reduce the effect upon residents in facilitating/providing continuity of care/support by using the same personnel. The home’s care staff has responded positively; working additional hours to meet the shortfall. The dependency/needs level of the service users
Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 18 continues to increase as the resident’s age increases and physical abilities wane. This places additional demands upon the care staff and is monitored by the home’s management. The Authority provides staff induction and updates and training opportunities. National Vocational Training and assessment to meet the required minimum level is ongoing. A number of personal portfolios have been submitted for assessment, their auditing had been delayed by loss of staff with the Authorities training department. Staff was positive and keen to extend their range of skills and knowledge Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. The Management team’s enthusiasm and positive approach clearly influences the team’s approach and benefited residents. Risk assessments identifying areas of concern and maintain user safety had been undertaken. The building continues to require further improvements but is a “happy” care environment
Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 20 EVIDENCE: The management team had been recently strengthened by the appointment of a shift manager. Senior members of the team share managerial responsibilities and roles. There is always a senior member of the team on duty at the home. Residents confirmed that they can always talk to someone if they want or need to. Don View management team is responsible for the Day Care Service that shares the site. It currently impacts upon the quality of daily life and care provided at Don View. The Day Care Service Users access via Don View has been with work to change access to commence shortly. Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 ENVIRONMENT Standard No Score 19 3 20 3 21 3 22 3 23 3 24 2 25 2 26 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 37 3 38 3 Don View DS0000031838.V259688.R01.S.doc Version 5.0 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. 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 Good Practice Recommendations Standard OP26OP25OP24 Continue the refurbishment and redecoration programme as listed within action plan. Don View DS0000031838.V259688.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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