Inspection on 17/09/08 for Duncan House

This inspection was carried out on 17th September 2008.

CSCI found this care home to be providing an Excellent 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.

Other inspections for this house

Duncan House 09/01/06

Duncan House 15/07/05

Duncan House 16/06/04

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Duncan House 18 Huckleberry Close Purley on Thames Berkshire RG8 8EH     The quality rating for this care home is:   three star excellent 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: Jill Chapman     Date: 1 7 0 9 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. the things that people have said are important to them: They reflect 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: · · · · 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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 28 Information about the care home Name of care home: Address: Duncan House 18 Huckleberry Close Purley on Thames Berkshire RG8 8EH 01189 439460 0118 942 6671 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Purley Park Trust Ltd Mrs Susan Joan Bateman care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users to be accommodated is 8. The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disabilities (LD) Physical Disability (PD) 0 0 Over 65 0 0 Date of last inspection Brief description of the care home Duncan House residential care home is owned and managed by Purley Park Trust. It is one of five houses built to replace the old Purley Park residential home and former school. There are eight purpose-built units and a clubhouse on the attractively landscaped site. Duncan House has two storeys and can accommodate eight adult Service Users who have a learning disability. The site is enclosed apart from the entrance area and the trust has created a community within which Service Users can circulate freely without the need for direct staff support and where they are able to Care Homes for Adults (18-65 years) Page 4 of 28 visit friends in the other houses. There are parking facilities on the site and there are good public transport services near by. Scale of fees charged at 27.07.06 = #520--#740.45 per week. Care Homes for Adults (18-65 years) Page 5 of 28 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 10:15 am and was in the service for five hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgments about the standard of the service. The inspector met with the Team Leader, two Support Staff, the Care Manager and the Care Homes for Adults (18-65 years) Page 6 of 28 Responsible Individual. Discussions took place with residents either individually or in a group during the course of the visit. A tour of the house and garden was carried out and records relating to care, staffing and health and safety were sampled. The current weekly fees for the service are £547-£1,031. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 28 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. 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 10 of 28 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. The home only admits residents whose needs they can meet. Residents are given enough information about the home to help them decide to live there. Evidence: The Trust has a Statement of Purpose and Service Users Guide and these are produced in a format that is easier for residents to use. Copies of these were seen on residents files and show that they have been given these. There have been no recent admissions to the home but there was information available to show that a new resident would be fully assessed to make sure the home could meet their needs. The inspector was shown evidence that the Trust is adopting a new system developed by The Berkshire Care Association and that a senior manager from the Trust has been involved in the development of this. The Care Planning and Resource Pack includes a comprehensive admissions assessment that includes identifying prospective residents support, behavioural, communication and religious or Care Homes for Adults (18-65 years) Page 11 of 28 cultural needs. The admissions process includes introductory visits and seeking assessment information from other professionals involved with the resident. It was seen that the Trust has links with a local advocacy service if prospective residents needed support during the admissions process. Residents files sampled show that they are given a copy of their contract. Care Homes for Adults (18-65 years) Page 12 of 28 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 individual needs and choices are met by their care plan. They are encouraged to make decisions and to take acceptable risks to develop their independence. Evidence: Three residents were case tracked and their files showed up to date care plans that had been reviewed recently. A resident talked about his recent review and reviews were booked to be held on the inspection day. Care plans showed what support is needed to meet individual needs and daily diaries show that care plans are carried out. It is planned that care plans will be updated to the new Berkshire Care Association format in the near future. Care Homes for Adults (18-65 years) Page 13 of 28 There was good evidence that residents are encouraged to make decisions about their day to day lives. They have formulated their own house rules and they plan the weeks menu. Any restrictions in individuals decision making is part of agreed behavioural plans and it was seen that these boundaries have have had positive outcomes for the residents concerned. Files seen show that there is a robust system of risk assessment in place. Risk assessments were up to date and clearly showed how to minimize the risks to the individual. Care Homes for Adults (18-65 years) Page 14 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have a stimulating lifestyle and choose from an excellent range of leisure and occupational activities. They are involved in the running of their home and the choice of meals provided. Evidence: There is excellent written, verbal and photographic evidence that residents in Duncan House participate in a wide range of occupational, educational, work and leisure opportunities. An activity timetable is on display and helps them know what is planned for their week. One talked about a work placement and another of on site gardening. Care Homes for Adults (18-65 years) Page 15 of 28 Some educational courses are held on site by staff from a local college. The Clubhouse on site provides a good venue for visiting entertainers, bands and discos. Residents have the opportunity of taking part in the Gateway Award scheme that helps them develop skills and achievements. The on site gardening department enables involvement in gardening projects. There is good integration into the local community with residents attending local churches and clubs. There are cars and minibuses available to be booked for appointments and outings. Staff in the Trust are innovative in developing opportunities for residents to widen their experiences and skills, for example camping weekends on and off site. Some residents have enjoyed or are planning their holidays and talked about these. One said he had purchased new clothes for his holiday. Residents confirmed that staff support them to keep in contact with family and friends. Some residents are married or have a regular partner and staff support them to have appropriate accommodation in the home and the privacy to develop these relationships. Residents are involved in the choice and preparation of their meals. Food is stored at the correct temperatures and staff are trained in food hygiene. Menus show a selection of healthy meals on offer and the budget is managed to allow for the occasional takeaway or meal out. Care Homes for Adults (18-65 years) Page 16 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is very person centered, residents have a lot of choice in their daily care and house routines. Their health care needs are well met. Staff are trained to support residents to take their medication safely. The Trust helps residents say goodbye to deceased friends in the way that they choose. Evidence: Residents confirmed that they have choice in their daily routines and this was observed during the inspection. Information in residents files shows their preferences in their personal care routines and their likes and dislikes. Guidelines are in place to make sure that staff are consistent in their approach with residents who need help with behavioural needs. Residents dress according to their personality and taste and they confirmed that staff support them to buy clothes of their choice. Residents were at ease in their surroundings and with staff. They conveyed a sense of ownership in their home. Care Homes for Adults (18-65 years) Page 17 of 28 Health care needs are well documented. Residents and staff talked about appointments for residents with various health professionals and these are clearly recorded on individuals files. One resident attends health appointments independently and others are supported by staff. The medication system was seen and showed that this is stored administered and recorded safely. The home has a good working relationship with the pharmacist who carries out an annual inspection. Staff are trained in house and also by an accredited trainer to make sure they are competent to give medication. On the day of the inspection a funeral was held for a resident in one of the other homes on site. Some residents from Duncan House chose to attend and talked with staff about their feelings about the loss of their friend and their mixed feelings about attending the funeral. Others made it clear that they had chosen not to attend and were equally supported by staff to talk about their feelings. Staff at all levels were represented at the funeral and the respect for the deceased individual was evident throughout the site. Care Homes for Adults (18-65 years) Page 18 of 28 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. Residents know who to talk to if they have a concern. Staff are trained to know how to protect residents from potential abuse. Evidence: The Commission has not received any information from other people about any complaints made about the home and the home has not received any complaints. Files sampled show that residents are given a copy of the complaints procedure in a format that they can understand. Those spoken with confirmed that they knew who to speak to if they are unhappy about anything. Staff are given information about the complaints procedure during their induction and staff spoken with confirmed they knew what to do if one was received. The Commission has not received any information about any safeguarding issues relating to the home and they have not needed to make any safeguarding refferrals. The home has a policy on the prevention of abuse and also an up to date copy of the local safeguarding procedures. Staff are trained to recognize and report potential abuse and the manager has been accredited to provide this training. Care Homes for Adults (18-65 years) Page 19 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from an excellent standard of accommodation. They live in a well maintained and homely environment that meets their needs. The home is kept clean and hygienic by staff and residents. Evidence: A tour of the house and garden shows that residents benefit from an excellent standard of accommodation. The house is modern and provides attractive, spacious communal and private accommodation. Most bedrooms have an en-suite walk in shower room. Two bedrooms share an attached private bathroom, that can provide suitable accommodation for a couple. Furniture and furnishings are modern and qood quality. Residents bedrooms seen were well furnished and decorated and personalized to individual taste. Since the last inspection the kitchen has been redecorated and a larger dining table has been purchased to enable staff to sit with residents at mealtimes. New garden furniture has encouraged residents to use this in the warmer weather. Some residents have been involved in a project to help staff build an additional patio area and this has improved access for visitors who use a wheelchair. Residents have also helped Care Homes for Adults (18-65 years) Page 20 of 28 develop the garden with the addition of many attractive plants. Two previous requirements have been met. Restrictors have been fitted to upstairs windows and paper towels are provided for communal bathrooms and toilets. The home is kept clean and hygienic by residents and staff. There is a well equipped laundry and cleaning materials are stored safely. The home is kept well maintained by the on site maintenance and gardening staff. Some residents talked about some of the benefits of living in a small community by being able to visit each others houses and the use of communal facilities such as the clubhouse and gardening workshop. Care Homes for Adults (18-65 years) Page 21 of 28 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. Residents are supported by a well trained staff team. A robust recruitment procedure helps keep residents safe. Evidence: Staff were seen to treat residents with respect and to listen patiently to their day to day concerns and queries. The AQAA (Annual Quality Assurance Assessment) states that staff are supported, trained and guided to respect residents. Staff induction covers knowledge about the various disabilities and illnesses of the resident group. It was seen that there are good relationships between Duncan House staff and other residents and staff on site. Staff deployment was verified and shows that this is flexible to meet the needs and activities of the resident group. Staff said they appreciate that rotas are planned well and help them achieve a good work life balance. Interviews with two staff and recruitment files sampled showed that a robust recruitment procedure is in place. The procedure includes carrying out the required Care Homes for Adults (18-65 years) Page 22 of 28 checks and references to make sure staff are suitable to work with vulnerable people. Staff spoken with were positive about the terms and conditions of working for the Trust. There is a programme of NVQ (National Vocational Qualification) training in place and staff were positive about the career path that is available to them working for the Trust. All staff have a training and development plan. The induction and training for new staff is intensive and this was confirmed by two staff spoken with. Staff morale was found to be good and there is a low staff turnover. Staff confirmed that there is a programme of regular supervision in place. Care Homes for Adults (18-65 years) Page 23 of 28 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 home is well managed by a qualified and experienced manager. Residents views are sought to help develop the service. Robust health and safety systems protect residents and staff. Evidence: A previous requirement that the Trust review the managers responsibility and role as registered manager for two services has been carried out. A new manager has been appointed solely for Duncan House. The manager is experienced and has the Registered Managers Award. The AQAA (Annual Quality Assurance Assessment) was well filled in. It shows how the home meets the standards and what improvements are planned. Regulation 26 visits are carried out by managers from other homes on site and records seen show that these Care Homes for Adults (18-65 years) Page 24 of 28 are carried out monthly. There is a strong senior management and administrative structure on site. The ethos of the management structure is supportive and enabling and provides opportunities for staff to develop their careers within the organization. There is a quality assurance system in place that includes a monthly quality assurance checklist and questionnaires for residents, relatives, staff and other stakeholders. The homes office is well organized and records were easily accessed in the absence of the manager. Records seen were up to date and well kept. There is a robust health and safety system in place, service and maintenance records seen were up to date. Staff are trained and kept updated in fire safety, first aid, minimum handling, food hygiene, COSHH, infection control, fire safety and risk assessment. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R 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 26 of 28 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 Requirement 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 Requirement 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 Care Homes for Adults (18-65 years) Page 27 of 28 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. 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. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!