Inspection on 18/04/07 for Dugdale House

This inspection was carried out on 18th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 but made no statutory requirements on the home.

Other inspections for this house

Dugdale House 26/04/06

Dugdale House 24/11/05

Dugdale House 08/04/05

Dugdale House 21/10/04

Dugdale House 17/05/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Dugdale House 1 Santers Lane Potters Bar Hertfordshire EN6 2BZ Lead Inspector Mrs Sheila Knopp Unannounced Inspection 18th April 2007 14:10 Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dugdale House Address 1 Santers Lane Potters Bar Hertfordshire EN6 2BZ 01707 642541 01707 643653 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) CareTech Community Services Limited Application to be received from Mr Y Aumeer Care Home 8 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (2) of places Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2006 Brief Description of the Service: Dugdale House is situated in a residential area on the outskirts of Potters Bar. It is run by CareTech Community Services Limited. The home provides full care services for eight service users with learning disabilities. The two storey detached house was converted into a care home in 1998. There is a front driveway and parking facilities. The ground floor comprises the office, lounge, dinning room, kitchen and two bedrooms with en-suite facilities. The other six bedrooms are on the first floor. These have no en-suite facilities. The toilet and bathroom facilities are nearby. Spacious grounds that are mainly laid to lawn with mature trees and shrubs surround the house. The patio and garden are accessible to wheelchair users. The current fees for the services range from £1000 - £1600 per week subject to individual contractual arrangements with funding authorities. Information about the service provided at Dugdale House and copies of inspection reports can be obtained from the manager. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection is based on an unannounced visit to the service where the inspector met seven people who live at Dugdale House and the staff and management team on duty. Relevant care, management and health & safety records were checked. Information received by the Commission since the last inspection has been reviewed. Survey forms were left for each individual. It was requested that where individuals needed support to express their views someone at their day service was approached so that an impartial view in confidence could be obtained. Health and social care professionals and relatives of each resident have also received surveys so they can contribute their views. At the time of writing this report survey forms had been received from four residents. CareTech has appointed a new manager since the last inspection. Mr Aumeer took up his post on 02/04/07 and was present for part of this inspection. What the service does well: This was appositive inspection. The people who live at Dugdale House and the staff who provide support were very open and welcoming. A resident ensured the inspector was offered a cup of tea on arrival in their home. A resident who completed a survey form said ‘ I like living in Dugdale House and the staff there. They treat me well..’. The people who live at Dugdale House have access to a range of educational and leisure activities that add purpose and structure to their days. They use local leisure and health care facilities. The residents have access to transport, which allows arrangements to be flexible and spontaneous. A resident who completed a survey form said ‘I get on well with the carers and they help me when needed. I like living here’. The people who live at Dugdale House receive very good support from staff, doctors and community health care specialists to maintain their health. Residents and their representatives are fully involved in decisions affecting their lifestyle and health. The people who live at Dugdale House are living in a well maintained environment which was observed to be fresh, clean, well furnished and decorated The management systems required within the home to ensure the safety and well being of people who use the service were well organised and up to date. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: CareTech need to ensure there is no delay in forwarding an application to the Commission to Register the new manager as required by the Care Standards Act. The new manager has identified service user involvement and communication as areas for further development. Two out of three residents who answered a survey question about being involved in decisions in the home said this happened ‘sometimes’. CareTech should consider replacement of the window frames in its development and renewal plan at a future date to ensure the window restrictors do not fail. The window frames are becoming worn and some of the joints have been repaired with metal brackets. More resources need to be made available to maintain and develop the garden so residents are able to make full use of it. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 7 Future planning should include a review of access to the first floor and first floor bathrooms to ensure the changing needs of residents can be met, as they get older. 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. The summary of this inspection report can be made available in other formats on request. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2 & 3 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People coming to stay at Dugdale House are provided with information about what they can expect and opportunities to try out the service, with the support of relatives and professionals they know, so they can see if it is the right place for them. EVIDENCE: A resident who completed a survey form said they visited Dugdale House before moving in. All four people who returned surveys said they liked living at Dugdale House. The care records of a person who has recently come to live at Dugdale House provided detailed information about the arrangements to support that individual as they came for day visits and as they settled in. This included support from other health and social care professionals who knew that person to make sure staff could meet their needs. Following admission staff continued to review and make adjustments to the assessments they had made as they got to know the person concerned. Residents have been provided with updated information about the service provided, including the costs and their contribution to the fees. The records seen indicated individuals had signed revised service agreements. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 10 Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 & 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who live at Dugdale House receive the support they need to make decisions about how they wish to lead their lives. EVIDENCE: Each person using the service has a very detailed person centred care plan, which identifies how they would like their individual needs to be met. The information had been kept up to date and reflected what the people using the service and staff had told the inspector about the support being provided. Where risks have been identified residents and staff have information about how this can be managed. There was evidence that individuals are involved and given support to understand the reason specific risk reduction strategies are used to promote their safety and improve the quality of their lives. Each resident has a key worker and information is displayed on a daily basis in pictorial form so they are aware of which staff are available and will be Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 12 supporting specific tasks and activities. Individuals were aware of who their key worker was and staff had a clear understanding of their role. So residents are fully involved in discussions about their lives and the running of the home each person has a monthly one to one ‘Talk Time’ meeting with a member of staff in a suitable place that is comfortable for them. This may be out at a day service or a trip to a coffee shop. Their goals and aspirations are explored and areas for further action are identified. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 & 17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to make choices and set goals to enable them to maintain family contact, be involved in the day to day organisation and running of their home, develop new skills and be involved in meaningful activities within the local community. EVIDENCE: The care records reviewed confirmed that the day services available reflected the needs of each individual in relation to their interests, abilities and age. Where individuals had identified through one to one discussion with staff or during reviews that they wanted different things to do the care records confirmed the action being taken to address this. Individual needs associated with culture and diversity are identified through assessments, reviews and one to one discussion with residents. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 14 In addition to the individual arrangements to attend educational and leisure facilities the people who live at Dugdale House are able to use local services such as shops, pubs, the swimming pool and library. Transport is available so activities and events can take place spontaneously. One resident showed the inspector their photo album, which staff keep up to date. This provided information about the birthdays and celebrations that family members had been invited to and the trips and holidays the resident had enjoyed. Each resident has an album, which provides a pictorial record of recent events in their life which staff can talk to them about. Individuals follow their own routines when they are at home including being involved household tasks. Menus are planned with the residents and information is available in pictorial form to assist them make decisions. Consideration is given to individual nutritional needs so that residents have access to healthy options. Residents and staff sit down to eat together. The tables were nicely laid and discrete assistance was given to those who required it to enable them to enjoy their meal. Aids to support independence at meal times were also in use. Staff receive training to communicate with residents in their preferred language. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 & 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use the service are provided with good support to make decisions about their health and lifestyle, which may have an effect on their quality of life. EVIDENCE: The personal health care needs of each person are clearly recorded. Annual health care reviews are carried out. Good work between local GP’s, the Community Learning disability Team and staff in the home to review the changing health needs of individuals and provide the most appropriate treatment to maintain their independence was identified. Each person living at Dugdale House has a Health Action Plan signed by the individual and their GP. This details agreements where lifestyle choices have been made to improve quality of life. The arrangements in place, for example to reduce smoking, were understood by the individual concerned and supported consistently by staff. Residents are encouraged to be active by taking walks to improve circulation and one person enjoys swimming. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 16 There are safe systems in place to support residents who take prescribed medication to ensure it is stored and given in line with the GP’s written instructions. The staff who administer medication have undertaken a 12 week training course and their competency has been assessed and is kept under review. The dispensing pharmacist also visits and provides a report on the systems. Where issues have arisen these are fully investigated and reviewed. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Arrangements are made for each resident to have time with individual staff to have their views heard and receive details of the action taken as a result of any wishes they have expressed. EVIDENCE: A resident who responded to a survey question which asked, do you know who to speak to if you are not happy? said ‘ I have a key worker and like talking to people. I know how to make my concerns felt..’. All four residents who completed survey forms confirmed they felt safe. Residents are invited to contribute their views and ideas on the running of the home together with other residents and individually. The system of identified one to one time with staff provides opportunities for individuals to express their own views in their own time without the intrusion of others. The records of the ‘Talk Time’ sessions provide details of the views expressed and follow up action required, which is them discussed and reviewed at the next sessions so the resident has feedback and is kept involved. Each person has a copy of the complaints procedure in their personal file. No complaints were reported to have been received by the company. No complaints have been received by the Commission between inspections. There is a positive attitude to managing any issues or concerns brought to the attention of staff. The action taken to address any problems includes Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 18 consultation with the person concerned and their representatives. The records provided good evidence of the action taken to address the concerns of residents and their relatives. Staff receive training in Safeguarding adult procedures. Information received by the Commission confirms that incidents and accidents are fully investigated in an open manner. The staff interviewed felt there was an open and positive culture within the staff team, which would enable them to raise concerns. No concerns regarding care practices or approach to residents were reported. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who live at Dugdale House are provided with clean comfortable well decorated home. EVIDENCE: A resident who completed a survey form said the home ‘is well run and clean’. All areas of the home were found to be fresh and clean. Comfortable good quality furniture is provided. There are lots of homely touches with photographs of the residents displayed. The residents who invited the inspector to see their rooms were positive about their individual arrangements. Some residents have their own key. They are involved in choosing items to personalise their rooms. Locks on bedroom and bathroom doors provide residents with privacy. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 20 The manager reported that there are plans to make a computer available for residents to use, which will support leisure and educational activities. Overall the home was found to be well maintained but there are some areas the company will need to consider in its plans for the future. The wooden window frames are becoming worn and some of the joints have been repaired with metal brackets. CareTech should consider replacement of the window frames in its development and renewal plan to ensure the window restrictors do not fail. Also as residents become older access to the first floor and a review of the bathing facilities will need to be carried out. No concerns were identified in relation to the fire safety systems on this occasion. There are large gardens to the front and back of the building, which are managed by staff and the help of the company maintenance man. The lawn is meadow like and there are large over grown shrubs around the edge. It was reported the company are reviewing the gardening arrangements. They may wish to consider providing pathways, sensory features and seating areas so residents can enjoy the full extent of the gardens as well as the patio area. There is a small laundry, which residents can use. There is no space for a hand basin, which means residents and staff cannot wash their hands before leaving the room to reduce the risk of spreading infection. The manager following recent training has also identified this and has agreed to provide a suitable alternative hand cleansing system to promote good hand hygiene. Liquid soap and disposable paper towels are available in other areas as required. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 & 35 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use the service continue to be supported by a stable staff team who are familiar with their needs and have a range of skills and experiences. EVIDENCE: All four people who returned survey forms said staff treated them well. One person said ‘ I like the staff and they are friendly’. Positive interaction between residents and staff was observed during the visit. Staff were on hand to assist where required but also felt able to give residents the opportunity to follow their own routines and preferences. Detailed information is passed between shifts to provide residents with continuity and ensure staff are aware of any changes. The records of four staff who work in the home were reviewed. This confirmed that the required checks are carried out on staff before they start work with vulnerable residents. Staff receive the training they require to carry out their Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 22 role when they start and there is a planned programme of development leading to NVQ qualifications. Training is arranged to meet the changing needs of residents as they become older. Staff have regular supervision sessions with senior staff to enable them to discuss the running of the home and their own professional practice. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 & 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are good systems in place to ensure that residents are provided with a well managed safe home to live in where their rights are respected. EVIDENCE: The new manager will need to apply to the Commission for Registration. This was subject to a previous requirement but there has since been a change of manager who has confirmed he is in the process of completing the application form. CareTech has quality assurance systems in place, which include seeking the views of the people who use the service and key people involved in their lives. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 24 Detailed reports of the monitoring visits carried out by senior CareTech managers to ensure appropriate standards are being maintained were available. The views of residents are included in the report providing residents with confidence that their quality of life is kept under review. The management systems within the home were very well organised. The systems in place to enable residents to have access to personal funds were in order. The records of routine servicing, maintenance, fire equipment checks and fire drills were up to date. Staff training records confirm staff receive the required health and safety training to promote the safety of residents and their colleagues. Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 25 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 Standard No Score 1 3 2 3 3 3 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 27 28 29 30 3 3 x 3 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 3 x Version 5.2 Page 26 Dugdale House DS0000019329.V336019.R01.S.doc 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Dugdale House DS0000019329.V336019.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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