Inspection on 09/05/05 for New Dawn

This inspection was carried out on 9th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 but made no statutory requirements on the home.

Other inspections for this house

New Dawn 27/10/08

New Dawn 31/10/07

New Dawn 02/10/06

New Dawn 29/11/05

New Dawn 18/01/05

New Dawn 10/05/04

Similar services:

Coopers Mill Ltd

Pocklington House

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 New Dawn Dog Lane Horsford Norwich NR10 3DH Lead Inspector Dot Binns Unannounced 9 May 2005 9.45am 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 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 Stationary 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. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service New Dawn Address Dog Lane Horsford Norwich NR10 3DH 01603 891533 01603 890840 info@cmg-corporate.com Care Management Group Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Patricia Rolfe Care Home 20 Category(ies) of Learning disability (20) registration, with number Physical disability (20) of places Sensory Impairment (20) New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Twenty (20) people with a learning disability who may also have a physical disability and/or a sensory impairment may be accommodated. The total number should not exceed 20. Date of last inspection 18 January 2005 Brief Description of the Service: New Dawn is a care home providing personal care and accommodation for 20 Younger Adults with severe learning difficulties. A skill centre is located adjacent to the home and is attended by most service users.The home is owned by Care Management Group, whose head office is located in Wimbledon, London.The home is located in the village of Horsford, approximately 8 miles from Norwich. Local facilities, including shops, pubs and a post office are located within the village.The home is a single storey building with purpose built extensions. There are 14 single and 3 shared bedrooms. Communal spaces are spacious and light. Level access is available to the enclosed gardens and recreation area.Ample parking space is available to the front of the building. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced routine inspection and took place over two hours. The purpose of the inspection was to see how the Home was functioning on a normal day. During the inspection service users were observed with staff and a partial tour of the premises was made. The requirements of the last inspection were discussed with the manager and an examination of records and policies took place. There were no specific problems in the home during the last year which came to the attention of the Commission that needed to be discussed. What the service does well: What has improved since the last inspection? A new kitchen has been created which is bright and well equipped. Some radiators have been covered to ensure residents are not burned if they fall against them. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 6 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. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 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 standard(s) 1,2and 5 Information provided to service users could be better with a short service users guide. The information gathered by the home about a new service user is comprehensive and detailed. EVIDENCE: The Home has a very comprehensive statement of purpose supplying all the information expected in the regulations. It does not have a separate service users guide and is using the statement of purpose as the guide. This is quite a weighty document and a shorter guide in a format suitable for the service users would be more appropriate. In the two care records sampled, there was very good information about the person, describing their needs and abilities and giving background information. There was evidence of liaison with social workers and other community professionals. The Home also has a written admission procedure. Statements of the terms and conditions of the home were seen on two files showing that service users were aware of the costs and conditions of the Home. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 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 standard(s) 6,7,9 The assessed and changing needs of the service users are reflected very well in the individual care plans. They also demonstrate that service users are encouraged to lead as full a life as possible. Staff make every effort to understand what service users need and help them make as many decisions as possible. EVIDENCE: Two care records were inspected and were very good with detailed information about health, communication, personal abilities, activities, daily living skills and other topics. This information is an excellent help to staff in caring for the service users who in the main are not able to communicate very well. Monthly reviews of care are documented. A key worker system also operates in the home to ensure that each service user has a special worker who knows them very well and can interpret their needs and wishes. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 10 Because service users are not able to fully communicate their needs, staff have to be very sensitive to other signs of communication. The manager talked very fluently about how staff watch reactions and facial expressions to find out what service users like. Pictures are sometimes used and trial and error. In this way staff help the service users to make as many decisions as possible though staff do have to initiate activities. In the statement of purpose it also mentions that service users can choose their own routines, dictate their own appearance and given privacy in their room. This is a sound principle of care on which staff can build their practice. In terms of their own finances, the service users have assistance with this and an inspection of these financial records was made. Each service user has an individual financial profile outlining the benefits they receive and how they are dealt with. They are paid directly into bank accounts and two records were chosen and cross referenced with bankbooks. Deposits were seen going into the bank and outgoings were justified with receipts. The cash held on the service users’ behalf was checked against the record and found to be correct. Both care records showed that service users are supported to take risks as part of leading a normal life and there were risk assessments seen on sailing, road awareness and use of a paddling pool. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 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 standard(s) 13,14 and 17 Service users with staff assistance are able to use the community facilities. Service users are assisted to join in a very good range of leisure activities. Service users are offered a healthy diet and their enjoyment of the meals is monitored by staff. EVIDENCE: The home keeps an activities book which keeps a record of all the group activities taking place. Other individual outings are in the care records. The service users are profoundly disabled and most of their activities are outside the home accompanied by staff. The home has two minibuses and a car. Activities include, bowling, horse riding swimming and shopping. The manager said that in house activities include music and storybooks, and beauty sessions. One person is able to go to the shops alone. There are also individual outings for service users with their keyworker or outings for small groups. The manager gave examples such as one service user attending a gospel concert, another going to the ballet and of three attending a Kylie Minogue concert with an overnight stay in another home. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 12 Others have attended an open air concert at Blickling Hall. All these outings are shown in the care records. The policy on menus was seen in the manual and it said that all service users will have some involvement in planning the menus. However service users are not able to fully communicate in terms of having a discussion. The manager said however that staff are able to tell what they like and dislike by other means like gestures, facial expressions etc. and they have based the menus on this trial and error result. The Home uses a four weekly menu. Several service users are on a soft diet and one has liquidised food. A dietician is involved in planning for three of the service users. The cook was seen and confirmed what she was cooking for the main meal. Chilli or savoury mince was on offer with rice or potatoes and a choice of pudding. She confirmed what service users could have for supper and that staff offered service users drinks at regular intervals as they may not be able to ask for these themselves. She seemed to know the service users well and was quite positive about the food offered by the Home. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 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 standard(s) 18,19 The Home does have systems in place to ensure that service users are receiving personal support in the way they prefer. Service users physical and emotional health needs are met. EVIDENCE: The manager stated that most of the service users need help with personal care and some need two carers. Within that framework, the service users do still have a choice of what time they get up. There are male staff who help with the male service users but if they assist a female the manager said it is always done with a female colleague. The statement of purpose does mention the privacy and dignity of the service users being paramount and that they should choose their routines and dictate their appearance. The Home also has a key worker system to help with personal advocacy. This allows the key worker to interpret what the service user wants and help other staff to understand. The care plans confirm that there is lots of detail about preferred routines and likes and dislikes. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 14 The records showed that information about health was properly recorded and that service users had access to other medical professionals as well as a GP. There was evidence of referrals for physiotherapy, chiropody and the dentist and the speech and language specialist being involved. There was also evidence of how to deal with epilepsy with a chart monitoring frequency of seizures and actions to take. Flu vaccinations were also recorded. Service users also had access to their consultants. The manager reported that there was very good back up from the GP. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 There are systems in place for service users to have their views listened to. EVIDENCE: A complaints procedure was in place with the address of the Commission included. The procedure is also in the statement of purpose. There is also a complaints procedure in a picture format suitable for the service users. There is a key worker system enabling each service user to have one member of staff who knows them well and can be an advocate for them. This helps to ensure that service users are listened to. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 and 30 There has been some redecoration and repairs of the building but there are still improvements to be made to bring this Home up to standard. EVIDENCE: The bathrooms despite a requirement made at the last inspection are still in need of renovation. The manager described the plans for the bathrooms but these still need to be actioned. The lounge and dining areas were seen and were open and accessible giving plenty of space to the service users. Some areas need to be refurbished and decorated to brighten them up. The requirement made at the last inspection for the drain to be removed from the conservatory has still not been dealt with. There is however a new kitchen which is almost complete. The Home was free from offensive odours and has good facilities in the laundry. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Service users are supported by an effective staff team. EVIDENCE: Only part of standard 33 was inspected. The rota for the week of the inspection was examined and showed that six or seven staff were on duty during the waking hours with two waking staff on duty at night. This meant that staffing was provided in excess of what the Commission may have expected and considered enough time to take service users off the premises and ensure they are actively stimulated. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,40,41 and 42 On the basis of what was seen at this inspection, the home is well managed with records and policies in place. Where the manager has less control, for instance in the realm of budgets for building work, there is a slow response. EVIDENCE: The registered manager is very experienced and has worked with this client group for years. She is currently studying for her NVQ4 certificate in management though has a care managers award already. As this is a national company she is supported by a regional manager and a framework of policies from head office. There is a commitment to quality assurance with mention made in the statement of purpose and a full quality assurance policy. This outlines what an audit would ask eg “Does the service do what it says it is aiming to do?” There is also a questionnaire used for both service users and staff to gauge their views of the home. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 19 While not all the policies required for regulation were inspected, the Home’s manual of policies was seen and sample policies were read. Staff are reported by the manager to have access to these policies. The service users are not able to contribute to their making because of their disability. Records asked for during the inspection were provided and found to be properly maintained. Not every record required for regulation was inspected but those relating to the service users such as the care and financial records were examined. A requirement was made at the last inspection under health and safety issues about the need to cover radiators to prevent burning. This process has been started with five now covered. There is still more to do however. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x 1 2 x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x x 4 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 New Dawn Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 3 3 2 x I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 21 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 1 Regulation 5 Requirement The registered person shall produce a written service users guide to the care home as outlined in regulation 5 of the Care Home Regulations. The registered person is required to refurbish bathing and toileting facilities to ensure they meet the needs of the service users, including the fitting of appropriate aids and adaptations. Previous timescale of April 2005 not met. The registered person is required to relocate the drain cover located in the conservatory to the courtyard in order that the risk of tripping is reduced. Previous timescale of February 2005 not met. Timescale for action 31.8.05 2. 27 23(2)(n) 30.9.05 3. 28 13(4)(a) 30.9.05 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 42 Good Practice Recommendations It is recommended that the progress on the covering of I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 22 New Dawn radiators continues. New Dawn I55 S27338 New Dawn V226614 090505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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. 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