Inspection on 07/06/05 for Drakes Place

This inspection was carried out on 7th June 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Drakes Place 24/06/08

Drakes Place 15/01/07

Drakes Place 04/01/06

Drakes Place 02/02/05

Drakes Place 03/08/04

Drakes Place 24/02/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Drakes Place Taunton Road Wellington Somerset TA21 8TD Lead Inspector David Kidner Unannounced 7 June 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. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Drakes Place Address Taunton Road Wellington Somerset TA21 8TD 01823 662347 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) Voyage Ltd Care Home 27 Category(ies) of Learning disabilities registration, with number Physical disabilities of places Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 27 persons in categories LD and PD. 2. That Voyage addresses the need to ensure that the home is organised into clusters of up to 10 people by 1st April 2007 as stated in Standard 24 of the National Minimum Standards for Care Homes for Adults (18-65). Regulation 23 Care Homes Regulations. Date of last inspection 2 February 2005 Brief Description of the Service: Drakes Place is registered to provide care for up to 27 people with a Learning Disability. The home is owned by Voyage. Drakes Place is a large detached period property set in extensive and well maintained gardens. The home is within walking distance of Wellington town centre close to all local facilities and resources. The home has an on-site day resource. This provides opportunities for leisure, recreational and educational activities for all service users at Drakes Place. Resources include an art room, heated swimming pool and a computing resource. The home has twentyseven single bedrooms. Some are en-suite. The home has two lounge areas, two kitchen areas, a large laundry and a large dining room. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Part of the purpose of this unannounced inspection was to ascertain the progress the home has made in relation to the Unannounced Inspection that took place on 02.02.05. The inspector was made to feel very welcome at the home by the service users, manager and the staff team. Staff were very approachable and are committed in providing quality service to the service users that live at Drakes Place. There is a vacancy at the home for a Registered Manager. Presently, the Deputy Manager is acting as Manager at the home. Nine service users were spoken to at the time of the inspection. All service users were able to discuss the services that the home provides. The Inspector spoke to some service users in private and also held a small meeting with four service users in one of the lounge areas. Six staff members were spoken to, premises were viewed and the Inspector viewed records relating to staff recruitment, care plans, administration of medicines and health and safety matters. There are major plans to provide accommodation that is organised into clusters of up to 10 people by 1st April 2007 as stated in Standard 24 of the National Minimum Standards for Care Homes for Adults (18-65). Regulation 23 Care Homes Regulations. The home would benefit enormously from this as at present the home is in urgent need of redecoration and refurbishment. The Manager advised that matters relating to health and safety are addressed when identified. However, the home has not replaced broken tiles in one bathroom area that was identified at the last inspection conducted on 02.02.05. This is addressed in the main body of the report. Staffing levels have recently been improved. However, staffing levels must be further improved. The inspector acknowledges the commitment to addressing this matter. As a result of this inspection the home has five requirements and three recommendations. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.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 Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.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) 2 4 The home ensures the needs of service users are assessed prior to moving to the home. Service users, their family, care manager and previous carers are encouraged to visit the home. A trial period is agreed on an individual basis. EVIDENCE: The Inspector viewed documentation in relation to the recent admission of one service user. The service user had moved from another home within the organisation. The Care Manager and relatives had been involved in the process. The home had received the care plan, risk assessments and other appropriate documentation from the previous home where the service user was living. The previous Manager of Drakes Place had also visited the service user at their previous address. The Inspector viewed documents relating to the service user moving to the home. The service user had only been living at the home for a few days prior to this inspection and the manager confirmed that the care plan would be reviewed as needed. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 9 Staff that the Inspector spoke to confirmed that the service user had visited the home and had met other service users. The home has documentation of the visits made to the home, including overnight stays. Some service users that the inspector spoke to commented that the service user had visited the home and that they had met the person. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.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) 8, 9 Some service users care plans were not updated to reflect their current need, particularly in relation to their moving and handling needs. Service users are consulted and involved as much as possible in the running of the home. However, service user meetings are not happening as regularly as they used to be. The home supports service users to take risks as part of promoting more independent living. EVIDENCE: The Inspector viewed the care plans for three service users. All care plans had been reviewed on a monthly basis and some service users had signed their agreement. The care plan for one service user is currently under review following recent admission to the home. There was documentary evidence that users had recently seen their GP and other health care professionals and needed. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 11 The Inspector viewed various individual risk assessments. The Manager stated that the risk assessments for one service user are currently being reviewed due to their changing needs. It was noted that the moving and handling needs of some service users had not been reviewed for some time. The manager must ensure that the moving and handling needs of service users are reviewed on a regular basis. Risk Assessments must also be conducted. The service users that the inspector spoke to stated that they are consulted on a regular basis. At the time of the inspection the inspector noted staff offering choice and conversing with service users in a professional manner. Some service users commented that they have not had a residents meeting since Christmas. The Inspector noted that the minutes to the last service users’ meeting were dated Dec 04. The Manager stated that due to recent staff shortages service user meetings had not been held as regularly as they should have been. The Inspector recommends that these meeting are held on a regular basis. Particularly in light of the proposed changes to the environment. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.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) 13 14 15 16 17 The home encourages service users to become part of the local community by supporting service users to access local facilities and resources. However, extra staff resources would further promote this. The home encourages and supports service users to take part in a variety of leisure activities. Links with family and friends are promoted. The home promotes independence, choice and freedom of movement. The home provides meals that are healthy and reflect individual likes and dislikes. EVIDENCE: Service users that the inspector spoke to confirmed that staff support them to visit the local shops and facilities and go out on trips. Each individual monthly summary records the activities that have been undertaken. At the time of the inspection one service user was being supported to purchase personal items and a number of other service users had gone out for the day. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 13 Service users stated that family and friends are always made welcome at the home and can visit at any time. Service users can meet with family and friends in private if they so wish. Some staff that the inspector spoke to stated that staffing levels have improved over the last few weeks but if more staff were available all service users would be able to access more leisure, social and recreational activities. This is further commented upon in Standard 33. Service users have unrestricted access to the home and grounds. The home has a passenger lift and provides aids to promote mobility. The service users appeared very comfortable in their environment and at the time of the inspection were making the use of the lounge and outside areas. Some service users were engaging with each other, others watching television and others were taking part in craft type activities. Service uses commented the food is very nice and that choices are offered. Drinks are readily available. Following discussions with the Manager and some of the staff team, the Manager must explore ways in which meal times are more flexible, particularly at breakfast time. This will ensure that some service users do not have to wait too long until breakfast is served. The staffing levels are the main indicator for this being successful. Therefore, staffing levels must be reviewed to address this. This is identified in Standard 33. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.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 20 The home ensures that service users privacy, dignity and independence is promoted. Service users have access to health care professionals as identified in their individual care plans. The home does not fully ensure that all medicines are recorded in the correct manner. The minor shortfalls that were identified at the time of the inspection were discussed with the Manager. EVIDENCE: The service users that the inspector spoke to stated that the staff team are very nice and help them with their personal care as needed. Staff always knock bedroom doors and speak to them nicely. At the time of the inspection the inspector noted that staff were relating to the service users in a professional manner. Service users choose the clothing they wish to wear. Service users appeared to be well cared for. Care plans and daily running records confirmed that service users visit health care professionals when needed. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 15 The home had a Pharmacy Inspection on the 01.02.05. The Inspector viewed the MAR sheets. The manager must ensure that all hand transcribed medicines have two staff signatures and that variable doses are recorded on individual Mar Sheets. Both these issues were discussed with the Manager at the time of the inspection. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 16 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 The home has a Complaints Procedure, Whistle blowing Policy and a policy for safeguarding vulnerable adults. EVIDENCE: The home has a complaints procedure. There have not been any complaints to the home since the last inspection. Service users that the inspector spoke to demonstrated that they knew what to do if they were unhappy about something and how to make a complaint or raise their concerns. One of the newly appointed staff that the inspector spoke to was aware of the home’s whistle blowing policy. The inspector did not view individual service user financial records at this inspection. The Manager stated that she has arranged to meet with a building society to discuss matters in relation to opening bank accounts. This will be followed up at the next inspection. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 17 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 29 30 The home is in need of extensive redecoration and refurbishment. Staff are vigilant in ensuring that the home is kept clean and hygienic. This is not easy to achieve, as many parts of the home require redecoration. Staff are to be praised for their efforts in this area. The home provides specialist equipment to meet individual service user needs. EVIDENCE: There are major plans to vastly improve the environment for the service users at Drakes Place. The inspector did not view all areas of the home as the Commission For Social Care and Inspection (CSCI) is aware that the plan for redecoration and refurbishment is still to be confirmed. The CSCI has been advised that service users, their families and care managers have been and will continue to be consulted. At the time of the inspection the home appeared to be clean and hygienic. Communal areas and bathrooms were clean and free from malodours. Some service users bedrooms that the inspector viewed were also clean and tidy. It appears that staff are very conscious to ensure that the home is clean. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 18 The inspector noted that some tiles have not been replaced in one identified en-suite area. This was a requirement at the last inspection. The home must ensure that this is addressed so as to promote hygiene and health and safety. The Manager stated that she would discuss this with a member of the senior management team. The home has a passenger lift to the first floor. One service user showed the inspector their bedroom and used the lift to access the first floor. The home has specialist bathing, toilet, eating, drinking and hoist facilities. Some service users have electric wheel chairs and are able to get around the home with minimal or no assistance. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 19 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) 33 34 Staffing levels appears to have improved since the last inspection that was conducted on the 02.02.05. However, the Manager must review the staffing levels to ensure that there are sufficient numbers of staff on duty at all times. This was a requirement at the last inspection. The home has a robust recruitment process. However, it was noted that gaps in the employment history for some recently appointed staff had not been documented as being explored by the home. This should be addressed to promote good practice. EVIDENCE: The Inspector had detailed discussions with the Manager and some of the staff team. The staffing rota identified that staffing levels have recently improved and that the home is employing relief staff and agency staff. The inspector acknowledged that interviews to recruit more staff are due to take place in the very near future and that there is currently staff on maternity and long-term sick leave. On the day of the inspection there were nine care staff on duty in the morning/afternoon excluding the Manager and eight staff for the afternoon/ evening shift. Three waking night staff and one sleep over were on the rota for the evening. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 20 Service users and some of the staff team stated that at times there is still not enough staff on duty so as to provide all service users with the opportunity to access further leisure and social activities. It may also address the need to have more staff on duty at peak times such as mealtimes and during the day at Squirrel Lodge. The inspector viewed the staff files for recently appointed staff. The Inspector noted that there were gaps in the employment history of some staff. The home should explore these at interview and document this in the staff files. However, all newly appointed staff had a POVA FIRST check and were not working unsupervised. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 21 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) 42 With the exception of tiles in one en-suite bathroom area not being replaced, the home promotes the health, safety and welfare of the service users. EVIDENCE: The Manager assured the Inspector that the Company is addressing any areas of the home that require urgent attention to promote health and safety. The tiles in one en-suite bathroom must be replaced, as it is unclear when work is due to start on redecoration and refurbishment. The inspector viewed the records in relation to fire safety. The Fire Risk Assessment had been reviewed on 17.05.05. The local Fire Service visited the home in May 2005 and advised, “ that at the time of the visit a satisfactory standard of fire safety was evident”. Emergency lighting is tested monthly, weekly fire checks are conducted and recorded, a fire drill involving all service users and staff on duty was conducted on 16.04.05. However, the manager should ensure that the homes torches are maintained regularly. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 22 A satisfactory Environmental Health Inspection (food) was conducted on the 07.06.05. The Gas Safety certificate is dated 12.11.04. Portable Appliance testing was conducted on 01.11.04. The Electrical Safety Certificate is dated 04.11.02. All hoists and mechanical aids were serviced on 15.12.04 and the Passenger Lift was serviced on the 17.05.05. The home keeps records of all accidents at the home. The Manager stated that all accidents are now audited on a monthly basis. The inspector recommends that the audit process include the action that is taken by the manager for each accident if appropriate, as part of the audit process. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 23 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 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x 2 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x 3 3 Standard No 11 12 13 14 15 16 17 x x 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 1 x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Drakes Place Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA6 Regulation 15, 13(5) Requirement The manager must ensure that the moving and handling needs of service users are reviewed on a regular basis. The manager must ensure that the home has an effective staff team with sufficient numbers and complementary skills to support service users’ assessed needs at all times. This was a requirement at the previous inspection conducted on the 02.02.05. The manager must ensure that hand transcribed medicines are supported by two staff signatures and variable doses are recorded. The home’s premises are suitable for its stated purpose; accessible, safe and well maintained; meet service users’ individual and collective needs in a comfortable and homely way; and have been designed with reference to relevant guidance. This includes the replacement of broken tiles in one en-suite bathroom. This was a requirement at the previous inspection conducted on 02.2.05. Timescale for action 22.07.05 2. YA33 18 1 (a) 31.08.05 3. YA20 13 (2) 4. YA24 23 13 (4). To be agreed in the action plan for refurbishm ent. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 25 5. YA42 24 (4) c (iv) The Manager must ensure that the torches in the home are maintained with records kept. 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. 2. 3. Refer to Standard YA8 YA34 YA43 Good Practice Recommendations The Manager should ensure that service user meeting are held on a regular basis. The Manager should ensure that gaps in employment history for prospective staff are explored and documented. The Manager should ensure that the action that is taken by the Manager when auditing the accident reports are recorded in the homes records. Drakes Place D53_D02 S59632 Drakes Place V228665 070605 Stage4.doc Version 1.30 Page 26 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier, Taunton TA1 4AL 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. 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