Inspection on 08/04/05 for Dugdale House

This inspection was carried out on 8th April 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Dugdale House 18/04/07

Dugdale House 26/04/06

Dugdale House 24/11/05

Dugdale House 21/10/04

Dugdale House 17/05/04

Similar services:

Coopers Mill Ltd

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Paradise Lodge

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Upaya Ananda

Newton Court (1-2)

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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 Yoke-Lan Jackson Unannounced 08 April 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. Dugdale House Version 1.10 Page 3 SERVICE INFORMATION Name of service Dugdale House Address 1 Santers Lane, Potters Bar, Hertfordshire, EN6 2BZ 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) 01707 642541 01707 643653 Caretech Community Services Limited CRH Care Home 8 Category(ies) of LD - 6, LD(E) - 2 registration, with number of places Dugdale House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: The home may accommodate six younger adults with a learning disability who are aged up to 65 and two who are over retirement age. Date of last inspection 21/10/04 Brief Description of the Service: Dugdale House, located near the town of Potters bar, is one of the care homes provided by CareTech Community Services Limited. The home provides full care services for eight service users with learning disability. 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. The building itself is surrounded by spacious ground that is mainly laid to lawn with mature trees and shrubs. The patio and garden are accessible to wheelchair users. Dugdale House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection (Unannounced Inspection) for the year, 2005. The inspection took six hours. The inspection began with a tour of the premises. Two aspects of environmental hazards were identified. The members of staff immediately rectified the situation and removed the hazards (loose wiring and broken garden chairs). Work is underway to improve the front driveway to prevent water-logged patches. At the beginning of the inspection, one service user was present. She appeared neat and clean, dressed in her own clothes. Her gestures and facial expression suggested that she is comfortable. She showed the inspector her bedroom which was neatly kept with personal belongings (including cuddly toys and pictures on the wall) that reflect her lifestyle. The other service users returned from their respective day centres by late afternoon. They appeared happy and relaxed. The members of staff present included one senior carer, two support-care staff and one bank care staff. Group discussion and individual feedback from the staff suggested that the home is well managed. Good team work was evident. A couple of hours were spent examining documents and care plan files and the records examined were satisfactory, informative and up to date. However, the inspection revealed that the Commission for Social Care Inspections (CSCI) was not informed that the service user required Stoma Care (Nursing Care) at the point of admission. The service user has since settled down. The home has the support of the Health Care Team, including the General Practitioner and the District Nurse. The home has a new manager who was appointed in January 2005. The process for registration with the Commission for Social Care Inspection was discussed. Since the last inspection (dated 21/10/04), the home has one complaint that is currently being investigated. (Please see below for details of the inspection findings). What the service does well: Dugdale House Version 1.10 Page 6 The standard of care continues to be maintained in a consistent and positive way. All the members of staff have good knowledge of the service users’ needs and aspirations. Any changing need is noted and appropriate action is taken to ensure that the welfare and care needs of the service users are being met. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Dugdale House Version 1.10 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 Dugdale House Version 1.10 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) There has been no new admission since the last inspection. Currently the home has one vacancy. The home manager will ensure that any prospective service user admitted is not put at risk and that all care needs can be met at the point of admission and henceforth. EVIDENCE: Feedback from management staff and documents seen in the service user personal file notes of the service users confirmed that initial assessment were carried out by the provider, CareTech, before the home manager is involved. The most recent admission requires Stoma Care. Although the members of staff were trained by the District Nurse, who visited daily initially, the members of staff have no previous experience in Stoma Care. The home manager has assured the inspector that tfrom now on, the home will only admit a service user on the understanding that the service user’s needs and aspirations can be met at Dugdale House. Dugdale House Version 1.10 Page 9 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) The service users are given opportunities to make their own decisions about their lives. They are involved through staff guidance in all aspects of routine living in the home. The members of staff encourage and support the individual service user to lead an independent lifestyle. EVIDENCE: The care plans examined revealed that the assessed and changing needs of the individual service user have been routinely documented and updated. The daily record was up to date with information in regard to each service user. Each service user has a regular ‘talking time’ session with a senior key-worker that is documented. Alternative format of communication is used, including pictorial illustration. This was evident in the Care Plan file. Monthly staff meetings are held to discuss issues and to ensure that the changing needs of the individual service user are being met. Dugdale House Version 1.10 Page 10 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) Members of staff encourage and support service users to get involved in the activity programme which is planned to suit individual needs and interests. The majority of the service users have regular contact with their relatives. Arrangements are made for the relevant service user to visit relatives. The home provides transport. The home provides a balance and nutritional diet for the service users. The dietician visits once a month to ensure that the menu provided is suitable for the respective service users. EVIDENCE: The weekly activity programme for each service user was on display on the notice board. They each spend three days at the Day Care Centre of their choice. One service user attends the local college four days a week and participates in educational activities of her choice. The members of staff take turns to prepare the food. Service users are encouraged to help. Dugdale House Version 1.10 Page 11 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) All the service users are given one to one care and personal support. The service users’ physical and health needs are met. The administration of medicines are provided by trained staff. All the members of staff have commenced their training in “The Safe Handling of Medicines” provided by a local College. EVIDENCE: Evidence of recent referrals to health care specialists (General Practitioner and Mental Health Team) were seen. An appointment has been made for the Occupation Therapist to assess and advise on the bathroom facilities for one service user with restricted mobility. The Medication Administration Record Charts were examined and they were found to be correctly filled. Dugdale House Version 1.10 Page 12 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) The service users are given opportunities to express their views through regular ‘Talking-Time ‘ session with a key worker. An alternative format in communication is used during the session. The home has a system in place to ensure that the service users are protected from abuse, neglect and self-harm. EVIDENCE: The ‘Talking-Time ‘ sessions were documented, dated, signed and filed in the individual Care Plan file. Written risk assessments examined revealed that the individual service user is protected against self harm or neglect. A copy of the Hertfordshire Vulnerable Adult Policy and Procedures is kept in the office and is available to staff. Additional leaflets (issued by the Hertfordshire Social Services) on the prevention of abuse have been distributed to every member of staff. The home has a system in place to ensure that all members of staff have access to updated materials and information that are relevant in the day to day care of the service users. Individual staff member has to date and signed for each policy and procedure that is read and understood. Documented evidence was seen. Dugdale House Version 1.10 Page 13 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) The home appears homely and comfortable. There are ample shared spaces for the service users, including the large surrounding ground and garden, where service users are able to have daily walking exercise and outdoor activity. The premises are generally well maintained, clean and tidy. The facilities provided are adequate for the service users. Privacy is maintained. EVIDENCE: The premises appeared clean, tidy and odour free. The furniture and personal items in the individual bedrooms reflect the lifestyle of each service user living in the home. One service user has been transferred to the vacant room on the ground floor because of restricted mobility. An appointment has been made for the occupational therapist to assess the bathroom to ensure that the appropriate assisted bathroom equipment is installed for the respective service user. The home keeps a daily record of the water temperature which is thermostatically controlled. Dugdale House Version 1.10 Page 14 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) The home has an effective staff team. Members of staff have knowledge of each individual service user in their care and are aware of the service user’s likes and dislikes. The members of staff have undergone relevant training to meet the assessed and changing needs of the service users. EVIDENCE: Each member of staff is given a copy of the code of practice and conduct set by the General Social Council (GSCC). Over 50 of the carers have NVQ2 and NVQ3 qualifications. Members of staff confirmed that they are attending the six weeks training on the “Safe Handling of Medicines”. Other courses attended by members of staff included Falls, Sign language, Dementia, Epilepsy and Non-Violence, Stoma Care, Challenging Behaviour and Health and Safety. Arrangements have been made for staff to attend courses organised by the Hertfordshire Learning Disability Team. Dugdale House Version 1.10 Page 15 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) The members of staff interacted well with the service users who appeared happy and relaxed. Positive team working was evident. All these benefit the health and welfare of the service users. The new manager has taken steps to ensure that the standard of care continue to improve and to ensure that good practice is maintained. EVIDENCE: The current group of service users are not able to express themselves verbally. However documented evidence through revised policies and procedures and regular one to one session (between a key worker staff and each service user) indicated that the service users’ rights and best interests are safeguarded. Members of staff gave positive feedback about working in Dugdale House. Staff supervision and staff meeting are held regularly and documented. Discussion with the home manager reflected her enthusiasm to ensure that all her staff have the necessary skills and expertise to care for the service users. Dugdale House Version 1.10 Page 16 The home manager (formally deputy and acting manager) was appointed following the departure of the registered manager in January 2005. She is undergoing the six months probationary period, and will be required to undergo the registration process with the Commission for Social Care Inspection (CSCI). 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 3 x 3 Standard No Score Dugdale House Version 1.10 Page 17 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score 3 3 3 3 3 3 3 31 32 33 34 35 36 3 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 3 x Dugdale House Version 1.10 Page 18 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation No Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard No Good Practice Recommendations Dugdale House Version 1.10 Page 19 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Herts AL7 3BQ 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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