Inspection on 06/01/06 for Emmie Dixon Home

This inspection was carried out on 6th January 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Emmie Dixon Home 03/01/07

Emmie Dixon Home 25/07/05

Emmie Dixon Home 02/12/04

Emmie Dixon Home 11/05/04

Emmie Dixon Home 20/02/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Cuerden Grange Rest Home

Springfield Cottage

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 Emmie Dixon Home 149 Richmond Road Crewe Cheshire CW1 4AX Lead Inspector Maureen Brown Unannounced Inspection 6 January 2006 01:00 th Emmie Dixon Home DS0000006596.V279986.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 Emmie Dixon Home DS0000006596.V279986.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. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Emmie Dixon Home Address 149 Richmond Road Crewe Cheshire CW1 4AX 01270 581314 01270 210384 debbie.owen@emmiedixonhome.fsnet.co.uk 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) Emmie Dixon Home Ltd Miss Deborah Owen Care Home 12 Category(ies) of Learning disability (5), Physical disability (5), registration, with number Physical disability over 65 years of age (2) of places Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Registered for 5 physical disabilities PD, 2 elderly physical disabilities PD(E), 5 learning disabilities LD No more than 5 Service Users may be PD No more than 2 Service Users may be PD(E) No more than 5 Service Users may be LD Date of last inspection 25th July 2005 Brief Description of the Service: The Emmie Dixon Home is a two-storey adapted property that provides care for twelve adults (including one respite place) who have a physical and/or learning disability. Located in a residential area of Crewe, close to shops, pubs and other local amenities and local transport and road networks. Accommodation for service users comprises twelve single bedrooms, with one having an en-suite toilet/wash-basin facility. Whilst most bedrooms are located on the ground floor, there are four bedrooms on the first-floor which are used by service users who are independently able to negotiate stairs. There is a separate kitchen, laundry and office. Communal facilities comprise a main lounge, separate dining/lounge area, conservatory and toilets, bathrooms and a shower-room. Access to the first floor is provided by a stairway. The home has small paved/concreted areas to the front and side, where service users can sit. Parking is available on the road outside the home. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out during the afternoon of 6th January 2006. The total time on site was four hours. The inspector spent half an hour planning the inspection by reviewing the previous inspection report and service history. The inspection included a tour of the communal areas, inspection of records and discussions with six service users, the registered manager and the support staff on duty. Thirteen out of forty-three standards were assessed, most were met however, one immediate requirement was made with regard to the Gas safety and Electrical safety certificates. Feedback from this inspection was given to the registered manager at the end of the inspection. What the service does well: What has improved since the last inspection? Following previous recommendations records of residents’ weights were being regularly recorded and information regarding residents’ wishes with regard to dying and death had been gathered. Since the last inspection new flooring had been laid in the dining room and the kitchen had been redesigned with the false ceiling being removed and extra new windows fitted. This had improved the facilities for the residents making this area more light and airy to work in. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 6 Staff training has continued and further training is planned via an “on-line” computer system. What they could do better: 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. Emmie Dixon Home DS0000006596.V279986.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 Emmie Dixon Home DS0000006596.V279986.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): 5 The absence of important information in the contract means that residents’ needs may not be met. EVIDENCE: Residents had a copy of the contract between them and the home. It was signed by the resident and contained terms and conditions of residence, fees payable, personal support and services not covered by the fees. Also included were the rights and responsibilities of the resident and the proprietor and details regarding reviewing the care plan. However residents’ room numbers were not included and each contract seen showed out of date figures for fees. See requirement No. 2. Emmie Dixon Home DS0000006596.V279986.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 The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. EVIDENCE: Three residents’ care records were seen during this inspection. These were comprehensive and well presented in individual folders. Each contained personal information, risk assessments, information on personal care and visiting professional sheets. The care plans seen were drawn up in consultation with the residents and family and were based on their assessed needs and risks. Following previous recommendations residents’ weights are recorded and information with regard to dying and death has been obtained. Reviews undertaken by Social Services were not up to date. The manager stated she has contacted Social Services on numerous occasions to ask for these reviews to take place but this has not happened. Daily record sheets seen showed that day-to-day activities were recorded. This enabled staff and family members to see what a particular resident was undertaking during the day. They were easy to follow and were signed by carers. However some records were in red pen, which should be avoided, and Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 10 some of the terminology could be seen as judgemental or offensive in manner to the reader. Residents confirmed they had chosen the décor and furniture within their own bedrooms and it was seen that each bedroom reflected the residents’ personality and preferred taste of décor. Residents confirmed that visitors could be seen either in the communal rooms or their own bedrooms. Visitors were welcome at any reasonable time during the day and no visiting restrictions were in place. See requirement Nos. 3 & 4 and recommendation No.1. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 & 15 Residents’ were able to take part in a range of activities of their choosing. Personal and family relationships were encouraged by the home and the staff team supported people with this. EVIDENCE: The residents’ plans reflect the range of activities undertaken which included going for meals out, shopping, bowling, going to discos and the theatre. Residents spoken to said they enjoy going out and about in the community, to local shops and out for lunch. The residents had chosen to have a dog and they looked after him with support from the staff. Residents said they enjoyed taking the dog for a walk. This activity was seen during the inspection. Many of the residents had paid jobs, attended the local college or local day services centres. On discussion with residents they said that they enjoyed the jobs that they do and one resident was attending a course in catering at the local college. Other residents worked in the local charity shop. A car is available for the residents to get out and about in. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 12 On the day of this inspection three residents were out at local day centres; one resident was at the hairdressers; one resident was at work and one resident was at the local college. Visits from family and friends were recorded in the care plans and case notes. Residents shared with the inspector the contact they had with family members and said they could choose to see visitors within their own room or in the shared lounge, conservatory or dining area. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 Residents received support from the staff for personal care in accordance with their stated preference. EVIDENCE: Within the care plan descriptions of how the residents preferred to be supported in their daily routines were documented. Times for rising and resting preferred moving and handling techniques and personal care preferences were recorded, as was choice of clothing. All residents were dressed differently according to their own choice. During this inspection residents were getting ready to go out for a post-Christmas party. Staff were seen assisting some of the residents with their make-up and hair. Each resident had a health care action plan and visits to the dentist, GP, chiropodist, district nurse and aroma-therapist were recorded. The manager said that other specialist services could be requested through the GP as needed. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 14 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): 23 The policies and practices of the home ensure that service users are safeguarded from abuse and harm. EVIDENCE: The home had Cheshire County Councils’ local authority “no secrets” policy available and the manager confirmed that they would follow these guidelines in the event of an alleged or suspected case of abuse. The homes policy for the protection, management and prevention of adult abuse included information about signs of abuse, general indications to abuse, types of abuse and what to do in the event of witnessing abuse. Although staff spoken with confirmed that they had a good understanding of the potential indicators of abuse and what to do if they became aware of an allegation of abuse, formal training had not been undertaken. See requirement No. 5. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 15 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 & 30 The home provided a clean and comfortable environment for the people to live in. EVIDENCE: A tour of the communal areas was undertaken. The home was furnished in a domestic style with additional equipment such as hoists and tracking provided as necessary to meet the residents’ needs. Residents said that bedrooms were decorated to their preferred style. The home was clean, tidy and free from any unpleasant smells. The garden area is paved and the conservatory leads out onto this area. It is accessible to all the residents. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 16 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): 32 & 34 Records were well maintained. Staff received support to enable them to meet residents’ needs. Recruitment policies have been consistently followed resulting in residents receiving care from staff who have been properly vetted. EVIDENCE: At the time of this inspection the agreed staffing levels were met. Two care staff, the housekeeper and the home’s manager were on duty. Six of twelve staff had obtained NVQ level II or III in Care and two staff members were currently undertaking NVQ level II in Care. One member of staff is currently undertaking the NVQ Assessors Award and the two team leaders were due to start NVQ level II in Management. Mandatory training included moving and handling, first aid, food hygiene and medication training, which had been carried out by all staff. The recruitment procedure followed ensured that all the staff employed were suitable to work with vulnerable people. Two staff files were examined and these showed that pre-employment checks were carried out. Amongst the documentation available were two references, Criminal Record Bureau checks and a medical questionnaire. Copies of certificates of courses undertaken were also available. The files were up to date and well presented. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 17 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): 39 & 42 Residents’ views were used in the planning for the home. Decisions are influenced by the information obtained from the surveys and from conversations with residents. The arrangements currently in place do not fully protect and promote the residents’ safety and welfare. EVIDENCE: The manager had compiled a questionnaire for residents, respite and relatives and these were due to be distributed during February 2006. The results will then be collated and the information made available to residents, families, other professionals and the Commission. Other information is gained through discussions with the residents. Safe working practices included visits from the fire safety officer and the environmental health officer, which had been completed satisfactorily. The insurance certificate was in place and up to date. Fire alarm tests were being Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 18 undertaken on a weekly basis and records kept. Emergency lighting tests were also being carried out on a monthly basis with records kept. All staff had received fire awareness training. However, the gas safety and electrical safety certificates were not up to date and an immediate requirement was made. See requirement No. 1. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 19 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 X 23 2 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 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X X X X 3 X X 1 X Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA42 Regulation 23 Requirement Immediate Requirement: The registered person must ensure that up to date gas safety and electrical safety certificates are available. The registered person must ensure that each contract had the residents’ room number and up to date information regarding fees payable. The registered person must ensure that the Social Services reviews are kept up to date. The registered person must ensure that wording in daily records in non-judgemental and non-offensive in manner. The registered person must ensure that staff receives training in Protection of Vulnerable Adults from Abuse. Timescale for action 13/01/06 2. YA5 5 30/03/06 3. 4. YA6 YA6 15 17 30/03/06 28/02/06 5. YA23 13 30/03/06 Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 21 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 YA6 Good Practice Recommendations The registered person should ensure that red pens are not used in daily records. Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Emmie Dixon Home DS0000006596.V279986.R01.S.doc Version 5.1 Page 23 - 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!