Inspection on 24/10/08 for Durrants Care Services Ltd

This inspection was carried out on 24th October 2008.

CSCI found this care home to be providing an Good 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

Durrants Care Services Ltd 25/10/06

Durrants Care Services Ltd 10/03/06

Durrants Care Services Ltd 16/09/05

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Southfields

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Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Durrants Care Services Ltd Durrants Court Barn Ashford Road High Halden Kent TN26 3BS     The quality rating for this care home is:   two star good 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: Wendy Gabriel     Date: 2 4 1 0 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: Durrants Care Services Ltd Ashford Road Durrants Court Barn High Halden Kent TN26 3BS 01233851036 Telephone number: Fax number: Email address: Provider web address: joe.durrants@btconnect.com Name of registered provider(s): Name of registered manager (if applicable) Mr Joseph Graham Type of registration: Number of places registered: Durrants Care Services Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category 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 disability - LD Date of last inspection Brief description of the care home Durrants Care Services is registered to provide accommodation for 3 adults with learning disability. It accommodates service users with low to medium dependency needs. The Registered Manager, Mr Joe Graham has day-to-day responsibility for the Home. The home is a converted barn with accommodation on the ground floor. In the main house there are two bedrooms, one with a full ensuite shower room and the other has access to a bathroom. In addition residents share a very spacious lounge and kitchen/diner. The home is suitable for those with mobility problems. The annex, with a further bedroom would be used should the home increase numbers but this is Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 4 Brief description of the care home not being considered at this time. There is a decking area, outside which leads to a well maintained established garden. Within the garden there is a vegetable patch, greenhouse and fishpond. 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. For up to date information about the scale of fees, please contact the proviser. There are additional charges for hairdressing, magazines and newspapers and personal toiletries. 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We undertook a Key Inspection to the service. This means that the home did not expect our visit. We spoke to the deputy manager and briefly to the registered manager who called in during the inspection. The support worker on duty also spoke to us. The two residents were just about to leave for a shopping trip when the inspection started and this continued. When they returned they were noted to be happily occupied in activites that suited their abilities and individual choice. We looked at various documents and cross referenced them with records held in the home. There was limited conversation with the residents but staff were seen to be Care Homes for Adults (18-65 years) Page 6 of 28 communicating in a manner that the people preferred. An accompanied tour of the premises was undertaken. 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 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 Care Homes for Adults (18-65 years) Page 8 of 28 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 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. Prospective residents and their representatives have information to make a suitable choice about where to live. Prospective residents aspirations and needs are assessed. Evidence: The home provides a statement of purpose and service user guide. Prospective residents and their representatives have the opportunity to visit the home before making a decision to move there. An assessment is made of prospective residents and a review will be undertaken to ensure that peoples needs may be met in the home and that the individual is happy living there. Contracts seen were signed by representatives of the residents, this meets a requirement from the previous unannounced inspection. Care Homes for Adults (18-65 years) Page 11 of 28 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 are enabled to indicate choices and make decisions where possible. Risk assessments are benefitting by being updated to improve content. Individual care plans are in place and are benefiting from improved content. Evidence: Care plans are being renewed to include person centred planning and more detailed content. One basic person centred plan was seen and is being made more user friendly by the deputy manager. Basic reviews have been undertaken on care plans and this meets a requirement from the previous inspection. The deputy manager said she is going to include more detail as the plans are reviewed to detail fully any changes noted. Residents are supported to make decisions about their daily lives. Staff were noted encouraging interaction and responding in a kind and warm manner to suit the individuals. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: Risk assessments identify a range of activities in daily living and these are also being redesigned to include detailed information for staff actions to support residents where required. 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. Activities are encouraged in house and in the community. Appropriate family contact is encouraged. Residents are encouraged to indicate choices. Menus are varied and care is taken about choice. Evidence: Residents enjoy a range of activities and a member of staff and the deputy manager said that this had increased over the past year due to the residents being more inclined to be included. One person was excited at the prospect of a Halloween disco the following Saturday and her birthday party at a later date. Activity planners were viewed, these are updated as changes or choices occur. One person attends a garden/farm project, a facility at the nearby co-owned service. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: Bowling, dance and horse riding are attended and visits to the cinema, pub and club are encouraged. The deputy manager said that even if a person chooses not to stay at a venue for very long, their participation in the community where they can meet other people is of benefit to them. Social events are often held at the other home and residents are invited to participate as well. Future activities being sought by the deputy manager are swimming and ice-skating. The home maintains contact with families or representatives of residents. Menus are written monthly but are subject to change according to choice and activities. Care plans indicate if a resident is to be encouraged to avoid certain food types. Weight charts are maintained and the deputy manager agreed to contact a dietician for advice to support the homes practices to meet one persons needs. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive personal, physical and emotional support as preferred. Evidence: Medication is stored in a locked filing cabinet this is not the best means of storage. The deputy manager readily agreed to obtain suitable storage for medication that meets the requirements and guidelines of the National Minimum Standards and the Royal Pharmaceutical Society of Great Britain and agreed to obtain an up to date copy of guidance on the handling of medicines in social care provided by the Royal Pharmaceutical Society. The member of staff on duty and the deputy manager were very aware of the different needs of both residents. They individually and clearly explained administration procedures and reasons. The home is to seek advice regarding administration from the GP of a resident who has particular preferences when taking medication. This matter is also to be discussed with the individuals care manager. The deputy manager agreed to this. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: The homes medication policies seen on the day are basic. The home must have a written policy document for staff that sets out the general procedures for handling all aspects of medication administration. The deputy manager agreed to this. Staff are booked for a training course regarding medication administration in November. There was written evidence of the input of health care professionals being obtained by the home. The deputy manager has been gradually reviewing care plans and is planning to reformat some of the contents to provide a more descriptive text. Risk assessments identify areas in the daily lives of the residents and the deputy manager discussed plans to include more details to inform staff of actions regarding identified risks such as bathing. These have been regularly reviewed and dated but have not included any detailed observations of the review. 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 their views are listened to and acted upon. On-going staff training protects residents from abuse and harm. A complaint policy is to be displayed in the home and the homes complaints policy and procedures is to be made readily available in the home. Evidence: The homes complaint and procedures policy could not be accessed at the time although this was seen at a previous inspection. The deputy manager agreed to ensure a suitable policy is available in the home. A simple complaint procedure is to be displayed in the home, the deputy manager agreed to this. A complaint procedure is in the service users guide. The deputy manager is undertaking a further course on adult protection and confidently discussed adult protection procedures. Staff have adult protection training in November. Both members of staff has or are undertaking N.V.Q. level 3. It was evident from observation that one resident in particular feels comfortable and Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: secure voicing opinions to staff. Care Homes for Adults (18-65 years) Page 20 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. The people living in the home enjoy a comfortable and clean environment that is well maintained, clean and hygienic. Evidence: Durrents Court Barn provides a very homely environment for the two people living there. Each person has an attractive bedroom and individual bath or shower room. The deputy manager said that one person had taken great pleasure in choosing and then shopping for the colours for the bedroom. The home is comfortably furnished and was seen to be clean and hygienic. A garden surrounds the home and this is attractive and accessible. A small patio has been made to look colourful. There is some parking to the front of the home. Although the busy road is nearby, the garden and shrubs ensure privacy from passing traffic. 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. Competent staff supports people living in the home. Recruitment procedures protect residents and ongoing staff training meets residents needs. Evidence: Both members of staff has or are working towards NVQ3. The deputy manager confirmed that if there is only one member of staff on duty, she and the registered manager are quickly available if required. The member of staff confirmed that should assistance be required, support from the deputy manager and registered manager is available. They also stated that the nearby co-owned home is able to offer support should it be needed. The member of staff said that there is always a two hour handover period in the day when both staff are on duty as well as the deputy manager. The member of staff confirmed that she undertook induction when she started working at the home and a completed induction sheet was seen. Prior to starting work the member of staff said she undertook two training days in the home and that she was not able to commence work until her CRB checks and references had been obtained. The deputy manager agreed to obtain a more fulsome induction format from skills for care. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: A staff file was viewed. Some mandatory training had been undertaken and both the deputy manager and the member of staff confirmed that further training had been booked for November. Although the home has arrangements for support when there is only one person on duty, the deputy manager agreed to keep this under review to ensure peoples needs are met. 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. Residents benefit from a well-run home and know that their choices are enabled where possible. Health, safety and welfare is promoted. Evidence: The deputy manager is applying to become registered manager. This appointment will improve managerial input into the home and give the current registered manager the opportunity to take a different role in the organisation of the service. The deputy manager is working towards her NVQ level 4 and Registered Managers Award. Since the previous inspection, residents individual reviews and regular reviews in care plans and risk assessments have been undertaken. Where these have previously been just signed and dated they are now going to have thorough details of observations made in the intervening period of time between reviews. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The deputy manager said she is sourcing appropriate fire safety recording formats rather than the notebook records as at present. Fire drills are recorded and this meets a previous requirement. The deputy manager agreed to ensure the names of staff are recorded at each fire drill undertaken. The home is well maintained and service contracts were seen to be in date. 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!