CARE HOME ADULTS 18-65
Dunblane House 73 Bloomfield Road Blackpool Lancashire FY1 6JN Lead Inspector
Mr Kevan Royston Unannounced Inspection 7th August 2007 09:30 Dunblane House DS0000009914.V342463.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 Dunblane House DS0000009914.V342463.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. Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Dunblane House Address 73 Bloomfield Road Blackpool Lancashire FY1 6JN 01253 316125 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) Mrs Linda Margaret Parker Mr Robert Parker Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 05/09/06 Brief Description of the Service: Dunblane House is a small home registered for four persons with mental health problems. Dunblane House is a large terrace property close to public transport and local amenities in south area of Blackpool. There is a small garden area at the rear of the property with seating facilities. The front provides parking for two vehicles. There are three bedrooms, one is a double and two have ensuite facilities. There are sufficient toilet and bathroom facilities available. The ground floor consists of a lounge and dinning/kitchen area. There is also a conservatory at the rear of the property. There is a Statement of Purpose/Service User Guide, which is given to all prospective residents. This written information explains the care service that is offered, who the owners and staff are, and what the resident can expect if he or she decides to live at the home. The fees are £282.50 per week. There are additional charges for chiropody, which go up to £15.00. Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced visit undertaken over a period of approximately 6 hours on the 07/08/07 as part of the inspection process. The Inspector spoke to the homeowner, manager, one member of staff, and four residents. Some time was spent with the residents in a group sat in the lounge area. As part of the inspection process the inspector used case tracking as a means of assessing some of the National Minimum Standards. The process allows the inspector to focus on a small number of people living at the home. All records relating to these persons are examined and the rooms they occupy are looked at. The response from surveys sent to residents and relatives for there views on how the home is run was good, all four were returned by the residents and one from as relative. Comments were positive about the standard of care and support provided by the homeowners and staff employed at the home. There has been no new staff members employed for approximately four years therefore recruitment records were not looked at. A tour of the premises was undertaken. Examination of the homes documentation, policies and procedures formed the basis of the inspection process. What the service does well:
Everyone at the home support and encourage residents to pursue outside interests through education, employment and social opportunities well. This was confirmed through examination of daily programmes, and discussion with the residents and returned surveys. Comments from residents included, “I am just going to the centre its very good”. Also, “I work at the school part time”. A member of staff spoken to said, “We try and help and support them to do what they wish to”. There is very small settled staff team with no change in personnel for over four years, which helps relationships to develop between the residents and provide a better understanding of resident’s wishes and needs. Observation and talking to everyone at the home confirmed support, communication and knowledge of residents needs is excellent. One relative commented, “The home is small but he gets more one to one attention than he would in a large home”. A resident said, “More than happy here”. The manager spoken to said, “We know
Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 6 everyone that well we can tell if anyone is down or if something is wrong and deal with it”. The home has excellent, comprehensive and easy to follow recording systems of the residents care needs, general health and reviews of care, ensuring daily events are accurately recorded and resident’s health needs are continually monitored. There is two caravans in Wales available for the residents and provide holidays throughout the year which they visit on a regular basis. All the residents spoke of how they enjoyed going there. Comments included “Yes we have just come back its great”. And, “I love going to the caravan”. What has improved since the last inspection? What they could do better:
We found the homeowner meets minimum standards in all areas checked on this site visit and found the following advice will improve the way the home is run further: Continued redecoration and refurbishment around the outside of the building which is planned, will improve the facilities and provide pleasant surroundings for everyone living at the home. Please contact the provider for advice of actions taken in response to this
Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 7 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. Dunblane House DS0000009914.V342463.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 Dunblane House DS0000009914.V342463.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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment process is clear and precise to make sure the care needs of the residents are met. EVIDENCE: Records of two residents were examined and included completed assessment profiles so that a care plan can be developed. The written assessments seen confirmed there is involvement of the resident, social workers, other professionals and where possible relatives, to ensure the welfare and health needs of the residents are recorded in detail with as much information as possible. The homeowner spoken to said, “Anyone we assess to live here are welcome to dinner, overnight stays, weekend visits and relatives to visit”. Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9.Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are helped to make decisions, which supports them in their day-today lives, whilst taking into account risks. EVIDENCE: Two resident’s records were examined and included excellent detailed information about their personal, social, emotional, welfare and healthcare needs to ensure staff know exactly what is needed to provide and promote good quality care to the individual. One member of staff said, “We are updating all risk assessments. Records examined confirmed risk assessments are completed and reviewed regularly to ensure residents independence and living skills are developed in line with there care plans. Residents confirmed that they made their own choices in certain aspects of their life, such as going to the day centre and what activities and hobbies to pursue. Resident’s comments included, “I am working at the school cleaning and enjoy it”. And, “Five days a week I go to the centre”.
Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 11 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): 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Opportunities for development and community participation are addressed in the care plans, to ensure residents have opportunities for personal development. EVIDENCE: Dunblane House is a small family run home and the residents have lived at the home for a number of years, the homeowner is aware of making sure individual lifestyles are reflective of their needs and wishes. Recognising individual strengths and ensuring support to help achieve their goals that have been identified on care plans do this. A member of staff spoken to said, “Each resident has there own programme which we have worked out with them and we know what they want to do and how to support them”. Residents have a range of activities available to them, which include television, music, videos and board games. At the time of the visit the residents were sat in the lounge reading and watching TV after breakfast ready to go on there
Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 12 individual activity for the day. When spoken to one resident said, “I am just about ready to go to the center”. Another said, “I think I will go into town”. Meal times are flexible and cater for individual tastes. There was evidence of fresh fruit and vegetables in the kitchen to ensure residents receive a balanced nutritious diet. Details of individual preferences and dietary needs were recorded on the resident’s care plans to ensure their health and welfare is maintained. One resident who enjoys cooking said, “ I help out in the kitchen”. Another resident said, “Food is always good”. Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 13 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): 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents health care is taken seriously and needs are closely monitored ensuring health issues are met. EVIDENCE: Examination of records confirms there is good access to specialist healthcare services so that health needs are met and welfare continuously monitored. The records are well maintained and provide evidence the home works closely with the resident, their family if possible and other professionals so that everyone knows all about the specific needs of the individual. The manager said, “With us knowing the residents very well we can tell if there is a health problem”. Talking to the manager, homeowner and member of staff it was clear they all knew each residents personality very well and would be able to recognise any health problems should they happen. Medication policies have been updated and improved to protect and safeguard the residents. Medication records of resident’s case tracked were looked at and found to be in good order with only the trained personnel administering
Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 14 medicines to the residents. The manager said, “We have all now received medication training”. There has been training in areas of equality and diversity so that everyone understands the need to make sure no individual is disadvantaged due to any cultural or religious difference. Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 15 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): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for recording and reporting of complaints are good ensuring people feel listened to. The management and staff have good knowledge and understanding of safeguarding adult issues, which protect residents from abuse. EVIDENCE: There is a detailed complaints procedure, which is made available to all residents and relatives on admission and displayed in the Statement of Purpose and Service User Guide. There have been no complaints since the last inspection or over the last few years. Surveys returned from relatives knew how to make a complaint. One comment was, “Never needed to complain but would no who to speak to”. The management team and member of staff have all completed safeguarding adults training to ensure they know the procedure to follow and safeguard the residents. A member of staff spoken to said, “Now on the National Vocational Qualification (NVQ) abuse is covered”. Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 16 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): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is safe and clean maintained to a good standard providing comfortable surroundings for the residents. EVIDENCE: We walked around the building and found it to be clean and tidy. Observation walking around the premises found the decoration and furnishings in particular bedrooms have been improved and also one of the bathrooms redecorated and refurbished to ensure the building is continuously updated and provide comfortable clean surroundings. Bedrooms are individually decorated and furnished well. All rooms had good lighting and personalised by the families and residents to make it feel homely. The home has a laundry facility placed outside with policies and procedures in place to control the risk of infection.
Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 17 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): 32,34 and 35. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Recruitment procedures are robust to make sure residents are safe and protected should any staff be required. Training provided is good to ensure staff continue to develop their skills. EVIDENCE: Dunblane House is a small family run home with the same member of staff for over five years and the owners and staff are very experienced and competent to provide the care and support required by the residents. A member of staff spoken to said, “We work well together”. There is training for the staff member and she currently is undertaking level 4 NVQ and Registered Managers Award (RMA), which will enable her to have the skills and competencies to manage the home if required. There has been no new staff employed at the home since 2004. The manager is aware of the recruitment procedures; checks and disclosures required for any future staff should they be employed to ensure the safety of the residents is maintained.
Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 18 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): 37, 39 and 42.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and systems, policies and procedures are in place for the protection of staff and residents. EVIDENCE: The homeowner has a qualification in Social work and the registered manager has completed all the qualifications required to run and manage a care home and care for the residents. Both the manager and homeowner are now assessors for NVQ training, which enables them to support any staff employed at the home and provide in house training. The staff and management’s approach is relaxed so that there is no formality in the day-to-day running of the home. Residents are encouraged to follow Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 19 their individual routines supported by staff. One resident spoken to said, I like it here everyone is nice to me”. There is an annual development plan in place in order to continue to develop and ensure the safety and comfort of the residents. Regular staff and resident meetings are held informally and any important issues are recorded. Examination of records for residents confirmed they are comprehensive, well written and up to date. Records of money being handled for residents were up to date, explaining the reason for any expenditure and the balance of the money that was being retained. Examination of records and discussion with the manager confirmed good systems have been developed to gather staff, residents and relative’s views as part of his monitoring of quality to ensure the home is run smoothly and effectively. Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 20 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 X 2 3 3 X 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 X 27 X 28 X 29 X 30 3 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 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X X X X X 3 Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 21 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. 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 Dunblane House DS0000009914.V342463.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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
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