Inspection on 10/03/06 for Durrants Care Services Ltd

This inspection was carried out on 10th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Durrants Care Services Ltd 24/10/08

Durrants Care Services Ltd 25/10/06

Durrants Care Services Ltd 16/09/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Durrants Care Services Ltd Durrants Court Barn Ashford Road High Halden Kent TN26 3BS Lead Inspector Julian Graham Unannounced Inspection 10 March 2006 09:15 th Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 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 Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 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. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Durrants Care Services Ltd Address Durrants Court Barn Ashford Road High Halden Kent TN26 3BS 01233 850014 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) Mr Joseph Graham Mr Joseph Graham Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registration numbers to revert to three (3) when couple move out. Date of last inspection 16th September 2005 Brief Description of the Service: Durrants Court Barn Annex is registered to provide accommodation for 2 named adults with a mild learning disability. The company Durrant Care Service owns the business. The Registered Manager, Mr Joe Graham has dayto-day responsibility for the Home. The premise is an annex of a converted barn with accommodation on the ground floor. The self-contained accommodation comprises of a double bedroom with ensuite shower and toilet and a lounge/diner with kitchenette. There is a decking area, outside which leads to the garden, which is shared with the main house. The Home is situated on the main A28 in the village of High Halden. Within the village there is a pub, church, post office and village shop. The town of Tenterden is approximately two miles away. The Home is on the bus route to both Tenterden and Ashford. The Home also has transport, which can be used for Service Users if they wish. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and lasted around three and a half hours. Both the residents were at home at the start of the inspection and the inspector talked to them about the lives they are leading at Durrants Court Barn. The registered manager and one of the support workers were also spoken with. The premises was looked at briefly, and some of the paperwork was examined. The residents spoke about a particular issue relating to one of the staff, and a full and frank discussion took place with the residents and the registered manager about this. It was very evident that the residents are very able to express any concern they might have about the care and service they are receiving, in full confidence that they will be listened to carefully with any concerns taken seriously. The residents said “Joe (the manager) is very helpful to us.” The inspector was satisfied that appropriate action is being taken to address the concerns raised; although records of the specific complaint, and how the matter was addressed with the staff member in supervision, need to be better maintained. What the service does well: What has improved since the last inspection? What they could do better: Care plans and risk assessments must be reviewed and regularly updated. There must be a record of all complaints made, including the action taken to address the complaints and the outcome. Whilst there has been some improvement regarding medication procedures generally, some shortfalls remain to ensure residents’ safety. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 Page 6 Residents’ contracts must be agreed and signed by them. 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. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: These standards were not inspected on this occasion. The manager did however acknowledge that individual residents’ contracts were still not evidenced as agreed, which is outstanding from previous inspections. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 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 the following standard(s): 6,7,8,9, Residents receive good assistance and support to make decisions about their lives, and are consulted on all aspects of life in the home. Residents’ changing needs and current goals are however, not accurately reflected in their care plans and risk assessments. EVIDENCE: The care plans of both residents were viewed and these were very out of date and overdue for review. The manager said that there have been formal reviews with the placing authorities within the past twelve months, but copies of these were not on file. Whilst residents were clear that they are supported to take risks as part of an independent lifestyle, there has been no change to the written risk assessments, which remain in need of improvement as required in the previous two inspections. The inspector saw, through observing the interaction between the residents and the manager, that residents’ rights to make decisions are fully promoted and respected. One of the resident’s said “we are asked for our opinions and they do listen to us.” Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 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 the following standard(s): 11,12,13,15, Opportunities for personal development are given. Residents are being enabled to take part in a range of appropriate activities and are part of the local community. Residents are supported in developing and maintaining appropriate family and personal/intimate relationships. EVIDENCE: Residents are encouraged to be as independent as possible. Residents said, for example, that they prepare and cook their own breakfast and lunch and assist staff from time to time in getting the evening meal. The residents that they do the hoovering and polishing themselves, and one said they do their own ironing. Whilst residents are able to use public transport independently, and sometimes do, considerations of time and convenience mean that they tend to be taken into town by staff to do their shopping and for other activities. A full day programme is being enjoyed by the residents, including attendance at a local college. One resident said “it is my choice what I do during the day.” Residents are very much part of their local community, with one resident an active member of the local dramatic society and also helps out with a Brownie group. Residents said that they are continuing to receive help from staff and other professionals in the area of personal relationships. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 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 the following standard(s): 20 There has been some improvement with regards to medication, although some shortfalls remain, which potentially place the residents at risk. EVIDENCE: One resident is currently on medication, and it was good to see that this person’s medication was reviewed in October. Records are made of medication received into the home. Some shortfalls were noted on the MAR chart however, and include the need for handwritten entries to be signed and countersigned by two staff to minimise the risk of errors. The MAR chart must also clearly indicate the times of administration, including if the medication should be administered “when required”. When this is the case, the circumstances when it is appropriate to administer the medication should be clearly recorded. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 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 the following standard(s): 22,23 Residents know their complaints will be listened to and acted upon, although systems for the recording of complaints are unsatisfactory. Arrangements for protecting residents from abuse are satisfactory. EVIDENCE: The residents discussed an ongoing complaint with the inspector. The registered manager joined the discussion, and it was apparent that the concern is being looked into thoroughly. Residents said that they have full confidence in the manager, and have no difficulty in making their views known, knowing they will be taken seriously. The inspector observed the residents expressing their views with confidence, with full respect being accorded to them by the manager. There was no record of this complaint to examine however, and a system for the recording of complaints (complaints record facility) was not available in the home at the time of the inspection. The support worker on duty at the time of the visit, knew what action to take in the event of any allegation or suspicion of abuse. Residents’ monies are being handled appropriately, with records being well maintained. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 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 the following standard(s): 24 Residents benefit from a homely and comfortable environment. EVIDENCE: The environment was not viewed in detail on this occasion. The unit in which the residents live is self-contained, and those areas seen were personalised, attractive in appearance and very homely. The residents said they were very happy in the Annex, which they will be leaving soon to move back to the parent home, Boldshaves, but again in separate, self-contained accommodation. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,36 Staffing levels are sufficient to meet the needs of residents. The residents benefit from staff who feel supported. EVIDENCE: In addition to the registered manager, two care staff are employed, both of whom also live within the main house. These numbers are sufficient to meet residents’ needs. One of these staff was on duty at the time of the visit. This person said she enjoys her work, and feels well supported by the manager. She said she meets formally with the manager regularly, although records of these meeting are not being made. She confirmed that the manager is working with her closely regarding the issue referred to in the summary of this report, and that she is learning a lot about the work and what is expected from her. She and the manager confirmed that CRB and POVA checks were made at the time of her application and that references were taken up and verified. These records were not viewed as they are kept at the parent home, Boldshaves. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 Residents benefit from the ethos of the home which is open and inclusive. Some records are not being well maintained, and these need improvement. EVIDENCE: The registered manager has day to day control of the home, and is also the registered manager of a Leo Trust Home. Both residents spoke very highly of the manager, who was seen on the day of inspection to interact with the residents with much care, skill, respect and sensitivity. See the Section on Individual Needs and Choices regarding the requirements relating to the review and regular updating of care plans and risk assessments. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 Page 16 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 X 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X 3 X X X 2 x X Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 Page 17 yes 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 YA5 Regulation 5 Requirement Service User agreements to be agreed and signed by them (previous timescale 30/09/05 not met) Care plans and risk assessments must be kept under review and updated as required. Review medication system and address concerns highlighted in text of report Complaints must be fully recorded, with an account of the action taken and the outcome. Timescale for action 10/04/06 2. 3. 4. YA6 YA20 YA22 15 13(2) 22 10/04/06 17/03/06 10/03/06 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 YA36 Good Practice Recommendations Records to be maintained regarding staff supervision sessions. Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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. Extracts may not be used or reproduced without the express permission of CSCI Durrants Care Services Ltd DS0000064523.V266800.R01.S.doc Version 5.1 Page 19 - 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. 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