Inspection on 25/11/08 for Downing House

This inspection was carried out on 25th November 2008.

CSCI found this care home to be providing an Good service.

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

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10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Downing House Severn Drive Dothill Telford TF1 3JU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Moloney     Date: 2 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Downing House Severn Drive Dothill Telford TF1 3JU 01952381530 01952381531 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Telford & Wrekin Council care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 16. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disabilities (LD) 16 Date of last inspection Brief description of the care home Downing House is a purpose built building designed to be a home for up to sixteen people who have a learning disability. It is situated in the Dothill area of Telford and is owned by the local authority. It is a modern design and inside is divided into four areas. Three of those areas are laid out as flats for up to four people with the other area being further divided into four separate single flats. Each person has there own bedroom that has an en suite shower and toilet with those people who live in the single flats also having baths included in the en suite facilities. Each flat also has its own laundry facilities. The home is managed by Judith Pagett and she is helped in this task by her deputy manager and the rest of the staff team. The cost of living in this home is arranged by the local authority. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 16 Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A range of evidence was used to make judgements about this service. This includes records kept in the home, medication records, discussions with the staff team, a tour of the premises and talking with as well as observing the care experienced by people using the service. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People looking to use this service and their representatives have the information needed to choose a home which will meet their needs. They have their needs assessed and a contract which clearly tells them about the service the will receive. Evidence: The home was seen to have both a Service User Guide and a Statement of Purpose that contained the information required by people who may be considering living in there. Most of the people who now live in this home lived in the previous building of the same name and are therefore known to the manager and her team. One other person has been admitted since it reopened. The records showed and talking to the manager and the staff confirmed that a full assessment of his needs had been carried out before he was offered a place. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their lives and play an active role in planning the care and support they receive. Evidence: The files of three of the people who live in the home were looked at and both showed that the care for each had been regularly reviewed. A number of charts and documents that were in pictorial and other easy read formats were seen that showed that the likes, dislikes and wishes of the people living in the home were systematically being established in a person centred way. Staff confirmed that they had completed this task with as much input as possible from the person that the chart was about. Where activities had been identified there were records in place that showed that the staff had looked to see if there were any hazards involved and had established ways in which the risks could be reduced. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Other risk assessments were seen to be in place about such things as being in the homes transport. Talking to the staff on duty at the time of the inspection established that they were familiar with what these said. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home are able to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: Two of the service users records were looked. The activities noted ranged from attending local day services to social clubs to holidays and day trips to North Wales as well as a trip to see the Lion King in London. Risk assessments for a number of these activities were seen. Most of the people who live in this home attend day services provided by the local authority. Looking at the records and talking with the staff and the people living in the home showed that residents have regular contacts with friends and family where possible. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Talking with the staff also confirmed that the home has a vehicle that is available to get residents to the places that their support plans say they need to be. Talking with the staff confirmed that they know what individuals want to eat by talking to them and observing their reactions to different foods at meal times. The menus appeared varied and nutritious and talking with the staff alsoshowed that they were aware of the various dietary needs of the residents. When asked if she was enjoying her lunch one lady smiled broadly and said, I like it. All of the bedrooms were seen to have appropriate locks. Staff were seen to knock before they entered a residents bedroom or any of the bathrooms. The visitors book was seen to contain the names of numerous visitors. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: Looking at the service users records showed that health of each of the service users is closely monitored. Examples of the areas included in the monitoring were mobility, medication, one persons scalp condition and someday elses postural issues. A record of each visit to or by a health care professional was seen to be kept. Talking with one of the people who live at the home, the manager and the staff confirmed that these appointments had been made as and when necessary. Throughout this inspection staff were seen to treat the people who live in the home with dignity and respect. The administration and storage of medication was looked at with storage consisting a securely locked cupboard in each persons bedroom. At the time of the inspection no Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: controlled drugs were kept in the home. Appropriate administrative systems were seen to be in place and the records showed that they had been followed. The staff confirmed that only those who had received the appropriate training were allowed to administer the medications. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: The manager confirmed that the home has received no complaints. A copy of the homes complaints procedure was seen and this contained the information someone would need if they wished to raise a problem with the home or its owners. The home had a copy of the local policies and procedures for the protection of vulnerable adults which is part of the system that ensures that the service users are listened to and protected from abuse, neglect and self-harm. An issue that had been referred into these procedures was seen to have been handled appropriately by the staff at the home. Although the level of some of the disabilities of the service users means that they are unlikely to be able to access these formal policies, observation of the staff talking with them and each other indicated that they, the staff, would be aware of any dissatisfaction expressed and it was seen that a whistle blowing policy is available to be used. Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: The manager also explained that some of the service users monies are managed by the home. Full records were seen to be kept outlining any transactions and those records are monitored by the homes line manager and are also subject to checks by the authoritys accountants. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. Evidence: The home is divided into four distinct areas. Three of the areas are for groups of four people who share a lounge and a kitchen/ dining room. Each person has their own bedroom and each of those has its own en suite toilet/ shower room. Each of these three areas also has its own assisted bath and laundry room. The fourth area is for a group of four flats each of which is for one person. These flats consist of a bedroom, a bathroom containing a shower and a bath and a kitchen/dining/lounge area. The kitchen areas contained a combined washing/drying machine. Looking around the home it was seen that the people living there had personalised their own rooms and that some progress had been made in making the communal Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: areas more homely. A further laundry facility is also available to all of the areas should more heavily soiled items require washing. There is also a larger communal lounge that any of the people living in the home can use. This is on the first floor landing. A shaft lift is available for those people who may need or wish to use it. At the time of this visit the rear grounds had yet to be developed. The manager stated that it is planned that these should be usable in time for the warmer weather. There is a car park to the front of this facility. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who there and are able to support the smooth running of the service. Evidence: At the time of the inspection there were 4 staff on duty with one of them escorting one of the people who live in the home to the hospital. A number of the service users were attending activities that were run by local day service. The staff spoken to said that they thought that there were enough of them on duty to support the residents who were present. Those staff that were there were heard chatting to and engaging with the service users in a positive and supportive manner. Talking with the managers and the staff during the inspection confirmed that they have access to an ongoing National Vocational Qualification training scheme and a significant proportion of them have already achieved National Vocational Qualification 2 or above in care. The training records showed and the manager and the staff spoken to confirmed that Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: training in such things as food hygiene, infection control and moving and handling were up to date. The records of a number of staff recently recruited by the home were looked at. Only some of the records such as the Criminal Records Bureau notifications were available at the home and the manager stated that documents such as employment references were kept at the Civic offices. Previous inspections made of such documents has shown that the proprietor does not allow employees to start work with vulnerable people until these background checks have been completed. New staff also stated that they had undergone a formal induction process and the managers confirmed that appropriate foundation training was available to those who were new to the industry. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. The performance of the management is supervised by the proprietor but no evidence was found to show that they visit the home on a regular basis and meet with individual service users to make sure that their needs were being met. Evidence: The manager confirmed that she has gained the Registered Managers Award and National Vocational Qualification 4 in care both of which are appropriate qualifications for someone running a facility such as this. There should be monthly visits by the provider that are required by law to look at a range of issues that may affect how the needs of the service users are met. No records could be found of such visits taking place. However, the manager was able to confirm that she meets with her manager on a monthly basis to discuss her progress. Equality and diversity for the service users were seen to be promoted throughout the Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: home within the assessments, care plans and activities. Talking with the staff and looking at a variety of records confirmed that weekly checks take place on bath water temperatures and fire detection equipment. Other records seen, such as the fridge and freezer temperature records showed that food safety is routinely monitored. Accident records were looked at and these showed that such incidents were monitored by the senior management. The manager confirmed that the safety testing of portable electrical appliances would be taking place in the near future in line with the Authoritys policies and procedures. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!