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Inspection on 11/11/08 for Draycombe House
Also see our care home review for Draycombe House for more information
This inspection was carried out on 11th 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.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.
Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: Draycombe House Draycombe House 1 Draycombe Drive Heysham LA3 1LN 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: Jennifer Hughes Date: 1 1 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. They reflect the things that people have said are important to them: 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: ï· Put the people who use social care first ï· Improve services and stamp out bad practice ï· Be an expert voice on social care ï· Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information
Document Purpose Author Inspection report CSCI
Page 2 of 34 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 34 Information about the care home
Name of care home: Address: Draycombe House Draycombe House 1 Draycombe Drive Heysham LA3 1LN 01254858316 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Draycombe House Care Ltd Name of registered manager (if applicable) Mr Michael Raymond Wilson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: 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 Disability - Code LD The maximum number of Service Users who can be accommodated is:6 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home Draycombe House is registered with the Commission for Social Care Inspection to care for six adults with a learning disability. It is a large detached property, which is relatively close to shops and local amenities. The residents accommodation is situated on the ground floor. Each resident has a single bedroom and there is a large lounge, which has tea-making facilities within it, there is a separate dining room. Two of the bedrooms have en-suite facilities and there is a communal bathroom and a separate toilet. The current fees for the home are #361 to #779 dependant upon the individual?s assessed needs. Care Homes for Adults (18-65 years) Page 5 of 34 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 Care Homes for Adults (18-65 years) Page 6 of 34 How we did our inspection: This is what the inspector did when they were at the care home This was an unannounced visit to the home, meaning that the owner/manager, care manager, or staff did not know that the visit was to take place. This site visit was part of the key inspection of the home. A key inspection takes place over a period of time, and involves gathering and analysing written information, as well as visiting the home. During the visit we (Commission for Social Care Inspection) spent time speaking to residents, and also care staff and the care manager, who were the staff on duty. Every year the registered person is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of their service. It also asks about the registered persons own ideas for improving the service provided. We use this information, in part, to focus our assessment activity. Surveys were sent to residents and staff from the home, and any responses are included in this report. During the site visit, staff records and resident care records were viewed, alongside the policies and procedures of the home.
Care Homes for Adults (18-65 years) Page 7 of 34 We also carried out a tour of the home, looking at both private and communal areas. Everyone was friendly and cooperative during the visit. What the care home does well There is good information provided about the home for prospective residents, available in easy read and audio formats. There have been no admissions to the home since our last visit, but there is a procedure in place whereby a manager would carry out a thorough assessment of need of a prospective resident before they moved into the home. The individual would also visit the home to make sure it was the best place for them, and they liked it. We saw that information held by the home about each person created a clear picture of the person and how best to care for them. The care manager and care staff on duty at the visit were clearly aware of the individual preferences of each person living there, and the residents living there all had their own interests that they were encouraged to follow and develop. The care manager said that over the last year
Care Homes for Adults (18-65 years) Page 8 of 34 they have tried to involve family and friends, as well as trained staff, in decisions with the residents over promoting choice. I can decide what I want to do a resident told us. As part of her role one staff member has specific one to one time with residents. I like the one to one time I give - often its the little things that residents get such a lot of enjoyment out of. Like a bus ride along the promenade, or a shopping trip where I can give full attention to one persons needs and likes, she commented. We saw that staff worked with and chatted with residents all of the time, making sure all were included. The home is comfortable and clean, and the information sent to us confirmed that services to household equipment and appliances were up to date. All of the staff team hold NVQ qualifications. There is good communication and morale within the staff team. Care Homes for Adults (18-65 years) Page 9 of 34 What has got better from the last inspection The systems in the home are being updated, so that records are more structured and complete. This enables staff to provide the right care. Recruitment procedures are followed, and all documentation is available. Doors are fitted with devices which can hold them open, but which are connected to the alarm system and automatically release to allow the door to close if the alarm is activated. The care manager is aware of the need to provide a safe environment for the residents, and makes formal checks every week to assess any problems. Medication is stored securely in a locked cabinet. A monitored dosage system is used, and any medication is signed for at the time it is administered. Care Homes for Adults (18-65 years) Page 10 of 34 What the care home could do better All records should be complete, dated and signed for each resident, in order to make them relevant to the pattern of care provided. These records should give a clear audit path of the events in the life of each resident living in the home. Procedures need to be aligned so that the pattern is easy to follow. Presently there is information for each resident on a computer system, and some information written on file, with staff making records in several places. It should be made clear that residents are also involved in making decisions about their care. Medication is held in the home for an individual who does not live there, along with the medication administration record. It is not the responsibility of the staff of the home to monitor or administer this medication, and it should be removed. The temperature in all parts of the home should be monitored to ensure it is comfortably warm for the residents wherever they choose to go. The involvement of the residents in the recruitment process should be recorded. The quality assurance system for the home should be further developed, with recorded meetings, feedback from people involved with the service, either family, staff or professionals, and noted internal audits of records.
Page 11 of 34 Care Homes for Adults (18-65 years) The content of the Annual Quality Assurance Assessment should be improved to ensure it holds evidence of how the home is operating and developing, linked to the National Minimum Standards for Care Homes (1865). If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Jennifer Hughes 33 Greycoat Street London SW1P 2QF 02079792000 Care Homes for Adults (18-65 years) Page 12 of 34 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 13 of 34 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 14 of 34 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
. No-one moves into the home before having their needs assessed and being assured that these will be met. Evidence: There is detailed information about the home available for all residents, or prospective residents. This is presented in an easy read format, and also available in audio. The care manager we spoke to said that staff would explain the content to new residents. There have been no admissions since the last visit in November 2007. The care manager said that people would be assessed prior to admission to make sure it was the right place for them and the home could meet the needs of the individual. The assessment would be carried out with the resident, their family, and other relevant professionals. Social work assessments are used initially to decide whether an individuals needs can be met by staff at the home. The people living at the home had been there several years, and their current needs are well known and recorded. Care Homes for Adults (18-65 years) Page 15 of 34 Evidence: There was information on their needs, strengths, personal goals and choices. Care Homes for Adults (18-65 years) Page 16 of 34 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
. Residents are generally encouraged to make decisions in their lives, helping them to meet individual need, and make choices. Evidence: We examined the files of two residents living at the home. We saw that the care manager is developing the care plans to include more information about how to care for each person living there. He has initiated a review of the care for all residents by social services, and aims to make the information about each resident more person centred. This means that the information centres on the diverse needs of the residents rather than the needs of the staff who care for them. They detail each individual need and outline the task to be done in order that staff can care in the best way possible. It needs to be made clear that residents are involved in the decisions. We saw that the individual files are being reorganised and information is generally easy to find. We noted that one care plan was incomplete, and information did not always flow, as
Care Homes for Adults (18-65 years) Page 17 of 34 Evidence: a computer system was used intermittently with a paper system, occasionally making it difficult to follow. We discussed the need to align the procedures so there is a clear audit path. We saw that daily records are made for each resident by staff. These provide a full picture of peoples lives, giving evidence of the constant care provided, and background information for any future incidents. We discussed ways in which the records could be made more concise and easier to follow events for each person, and so easier to pick up any patterns of behaviour or illness. The discussion was about reducing the number of places staff are making records. Residents are supported to make their own decisions about their lives. Risk assessment procedures enable a full assessment of any risk allowing staff to know what action to take to enable residents to follow their chosen activity safely. One resident who did not easily recognise different coins and notes was noted as being at risk, and staff ensure they are always present to monitor when purchases are made by the resident. One staff member discussed the birthday celebrations of a resident with her. I want to go shopping and get some new boots, stated the resident. Staff agreed that was the plan, and chatted about what was going to happen and what else the resident wanted to do. Im having a cake, and some visitors. And a watch, the resident added. Since our last visit, Welfare Rights have helped some of the residents increase their income, which in turn has enabled the residents to be less restricted when looking at activities they want to do, or college courses they would like to attend. At our last visit it was noted that an individual who received support through a Supported Living Scheme provided by the owners of Draycombe House, called into the home on a regular basis, to pick up meals, or simply to visit. At this visit the individual called at the home, and we saw that the residents of the home were pleased to see him. We saw that rules were in place for the individual when visiting the home so that the privacy of the residents was respected. This must continue to be adhered to, as the priority of care in this home must be to the residents. The manager told us that he is aware the staff team need to spend more time to evaluate needs and choices, but over the last year they have tried to involve family and friends, as well as trained staff, in decisions with the residents over promoting choice. Care Homes for Adults (18-65 years) Page 18 of 34 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
. Residents decisions are respected and daily routines promote independence. Evidence: The manager stated in information sent to us, We meet the clients(residents) needs at a high level and promote a lifestyle they want to lead, and the residents are very happy and look forward to their daily life pattern. We saw that daily records gave evidence of a variety of activities residents enjoyed. Residents told us about their holidays in Blackpool, one of which they had just returned from. They told us about line dancing, going to college, Monday Club, MENCAP club, painting, bowling, shops,and the local pub. The care manager said that they try to give each person their own space from the family group, and try to ensure there are different things going on to encourage independence and individuality. He told us that he is continuing to look into activities
Care Homes for Adults (18-65 years) Page 19 of 34 Evidence: for residents. As part of her role one staff member has specific one to one time with residents. I like the one to one time I give - often its the little things that residents get such a lot of enjoyment out of. Like a bus ride along the promenade, or a shopping trip where I can give full attention to one persons needs and likes, she commented. Residents showed us their rooms, which were full of personal belongings and mementos. One resident loves music and playing records, which were all stored along a wall in his room. Staff encouraged him to play them, and talk about what he enjoyed, and seemed proud of the residents knowledge and ability to recall detailed information. We saw there were handicraft implements stored in a cupboard, and one of the residents said I like to sit in the lounge and do my knitting. She was sitting in a large armchair in the lounge, concentrating on her craft. One of the residents told us that they had family visit them at the home, although some of the residents have no known family. The care manager told us that they have been trying to involve the residents in the running of the home more, and residents confirmed that they may help in the kitchen, and sometimes washed and dried pots. All foods eaten are monitored and recorded. There is a weekly menu that has been decided on by the residents, who have a night each to choose what the main meal is going to be. They are able to have something different if they wish, and we saw plenty of food stored in fridges, freezers and cupboards to choose from. A resident confirmed that sometimes they go food shopping with staff. We were told about the need for food to be blended for one resident. Following our last visit and advice, the care manager had discussed with the resident and their family the possibility of presenting the blended meals in a more attractive way, and keeping the flavours separate. This resident prefers their meal as the home prepares them, but the care manager confirmed that he would address this if it arose with any new admission to the home. Meals are eaten at the large table in the dining room, which we saw was ready set with tablecloth and place mats for the next meal. We saw staff asking permission of residents to go into their room, and encouraged their assistance, for example Can you help me get your laundry from your room please? We saw that staff worked with and chatted with residents all of the time, making sure all were included. The dining room and the bedrooms were not very warm, a thermometer in the dining room stated it was 68 degrees. This needs to be monitored to make sure it is a
Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: comfortable temperature around the home as the weather gets colder. A staff comment on a survey was The home provides the means and opportunities for individual activities and choices. Care Homes for Adults (18-65 years) Page 21 of 34 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 staff have a good understanding of the residents support needs, so promoting good health. Evidence: All residents have a Health Action Plan, which is in the form of a booklet that holds all the information about the health and welfare of the residents. This may be visits to the doctor or dentist, what the visit was for, and when the next one is due. It notes their choices on how they like things done. Some of the information in these records was incomplete, although it could be found elsewhere in the residents file. When systems are used they must be used fully in order to make them relevant. We saw evidence of recent input from other professionals, such as psychologists, speech therapists and social workers. Strategies were in place where staff needed to manage the behavioural problems of a resident, and staff were able to tell us what those strategies were. I can see a doctor when Im poorly confirmed a resident. The care manager and staff on duty at this visit clearly knew the support needs of all the residents, who were happy to go where they wished in the home, coming and going to their rooms at will. The care plans we saw held plenty of information about
Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: the residents, guiding staff to look after them in the way that best suited their needs. Medication is stored in a locked metal cabinet fixed to the wall inside a cupboard. Most medication is in a monitored dosage system made up by the pharmacist, and the Medication Administration Records (MAR) we saw were up to date and accurate. The manager follows the good practice of confirming with the GP that any homely remedies taken by residents are safe. A declaration of wishes is signed by the resident, or their representative, to confirm whether they wish the home to administer their medication, or not. The care manager said he audits the medication every two months. Staff receive medication awareness training. The medication of a client of the Supported Living Scheme provided by the owners of Draycombe House was held in the home, along with their MAR sheet. This must be removed and held in the home of the client, as Draycombe House does not provide care to this person, and it is not the responsibility of the care home to monitor or administer this. Care Homes for Adults (18-65 years) Page 23 of 34 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
. The residents benefit from living in a home where their opinions matter, and their concerns are listened to and acted upon. Evidence: There have been no complaints received about the home since our last visit. The care manager told us that he has spoken to residents, families and representatives, to make sure the residents feel safe and secure at the home. A resident said she would Tell Steve (care manager), if they were unhappy. We saw the open atmosphere where the residents were freely telling staff what they did and did not like. Staff told us about safeguarding procedures. They said they feel they know the residents well, and also would look for behavioural changes and body language that may indicate that a resident was not happy. They also understood whistleblowing procedures, where staff are encouraged to report if they suspect abuse may be taking place. We saw that training in abuse awareness had been received by staff. Care Homes for Adults (18-65 years) Page 24 of 34 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. The residents live in a homely, generally comfortable, and safe home. Evidence: The manager stated in the information sent to us We plan to carry on with home improvements and continue giving the residents a good and safe home. We saw that the home is a Victorian style building with large rooms and high ceilings. Generally the home was comfortable and clean, but there were areas around the building that appeared tired, and needed some redecoration. The care manager told us of the difficulties of maintaining the type of building this was, and they were continually monitoring where the next refurbishment was to be. It was clear some areas had been addressed. The dining room had been redecorated, and a more homely light fitting put in place. Bathroom carpets had been put down. Some replacement windows had been fitted in bedrooms, although we noticed one had been leaking. The manager said he was aware of this and was addressing the problem. All of the bedrooms were very personalised, each showing the different personalities of its resident. The residents were happy to show us around their rooms, and pointed out their favourite pictures and belongings. The residents tend to stay in the large lounge with its comfy sofa and chairs, and television in the corner, when at home during the day. I like to stay in the lounge with everyone. Sometimes I go to my room to get
Care Homes for Adults (18-65 years) Page 25 of 34 Evidence: something, said a resident. Other residents we spoke to said that they liked living at the home and liked their rooms. The dining room is used by all the residents, and during our visit in the day we found this was not very warm, even though the radiator was on. The wall thermometer was at 68 degrees. The bedrooms were also not warm. These areas need to be kept at a comfortable temperature, to ensure the comfort of residents if they choose to stay in their rooms. Care Homes for Adults (18-65 years) Page 26 of 34 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
. The recruitment and induction procedure means that only people suitable to care for vulnerable people are working at this home. Evidence: We selected the files of two staff, and saw there were standard recruitment procedures, with references from past employers, and Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) having been applied for and received. The care manager confirmed no staff starts work before these checks have been received by the home. We advised a start date of employment be noted on the staff files. The care manager confirmed the recruitment process as consisting of a completed application form and interview. Then a second interview involving residents, where the applicants interaction would be noted. Along with satisfactory checks, the information would then identify whether the applicant was suitable for the post. We advised that the involvement of residents needs to be recorded as evidence this has happened, and with the outcome. We noted the staff had induction training, using the Learning Disabilities Award Framework. Training schedules for staff have improved since our last visit, the training being accessed through the Lancashire Workforce Development Partnership (LWDP). We saw a matrix prepared by LWDP for the home, showing training attended, and also
Care Homes for Adults (18-65 years) Page 27 of 34 Evidence: prompts for refresher training. Staff had attended courses including first aid, medication, bereavement, abuse awareness, challenging behaviour, moving and handling, Learning Disability Qualification, and National Vocational Qualifications (NVQ). All of the staff hold NVQ awards. One to one supervision of staff takes place every six to eight weeks, and helps identify any training needs. The manager should ensure all supervision and appraisal records are signed by the manager and relevant staff, and dated. The staff rota showed that there were appropriate staff on duty, with either two or three staff on in the day at any time, depending on what activities were taking place. We saw that the care manager has made good progress on improving the structure of staff records, and he needs to continue to do this to ensure an easy audit path through recruitment and induction, training and supervision. This is good evidence then that residents are protected as they are looked after by appropriate and trained staff. Staff we spoke to said they were well supported, and one said There is a good staff team and high morale. A comment in a staff survey said I am very happy in my work place. I feel we all have great working and personal relationships among staff and residents We spoke to staff on duty, and they were very aware of the needs of the residents in their care. Care Homes for Adults (18-65 years) Page 28 of 34 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 residents live in a home that is generally well managed, and their health, safety and welfare is of utmost importance. Evidence: The home has a long term registered manager who works with the intention of providing a good service to the residents. He employs a care manager, who has experience of learning disability service provision, and who has been working to restructure the documentation into an efficient system. This makes sure the residents information is up to date, enabling staff to provide the right care. The care manager is due to complete the Registered Managers Award. The information we asked for about the home was sent to us on time. We discussed with the care manager how this information could be much improved, with more detail about how procedures, linked to the National Minimum Standards for Care Homes, work in this home, with examples if necessary. Present residents are well established in this home, and all seemed relaxed and
Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: choosing to do whatever they wanted, telling the staff what they did or did not want to do. The care manager said they try to have a residents meeting about every three months, and staff meetings about every three months, although as this is a small home, the staff are seen all of the time by the managers, and the meeting is not needed. The care manager confirmed he makes a weekly check of the home, looking at fire doors and procedures, call bells in the bedrooms, and any outstanding maintenance issues. We saw a maintenance book and check list confirming work had been carried out. All accidents are recorded on file. Records were generally more accessible than at our last visit, and and the managers need to further work on the structure and consistency of them to ensure the working system is as efficient as possible. Care Homes for Adults (18-65 years) Page 30 of 34 Are there any outstanding requirements from the last inspection? Yes ï£ No ï 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 31 of 34 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 Description 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 Description 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 1 6 Ensure all records are complete, dated and signed for each resident, in order to make them relevant to the pattern of care provided. These should give a clear audit path of the events in the life of each resident living in the home Continue to ensure the privacy of residents is addressed and their care is the priority when visits are made by individuals from other service provisions. Ensure there are up to date records of residents agreeing to these visits. The medication for a client from another service provision is not the responsibility of Draycombe House, and should be removed and kept in suitable storage at the clients home or elsewhere. The temperature around all of the home should ensure the comfort of the residents wherever they choose to go. Record the involvement of residents in the recruitment process. Make sure all records are signed and dated, and there is a 2 7 3 20 4 5 6 24 34 35 Care Homes for Adults (18-65 years) Page 32 of 34 clear audit path in structured files through recruitment, induction, training and supervision to show that staff are appropriate and trained. 7 39 Improve the content of the Annual Quality Assurance Assessment to ensure it holds evidence of how the home is operating and developing, linked to the National Minimum Standards for Care Homes (18-65). Continue to develop the quality assurance system of the home, with recorded meetings, formal feedback from people involved with the service and clear audits of records, to help measure the success of the home in achieving its aims and objectives. Continue to restructure records to enable an efficient working system and so safeguard residents best interests. 8 39 9 41 Care Homes for Adults (18-65 years) Page 33 of 34 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.
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