Inspection on 21/06/05 for Plean Dene

This inspection was carried out on 21st June 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Plean Dene 12/08/08

Plean Dene 27/09/07

Plean Dene 23/02/07

Plean Dene 27/10/05

Plean Dene 19/10/04

Plean Dene 13/05/04

Plean Dene 24/02/04

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

CARE HOME ADULTS 18-65 Plean Dene 2 Luccombe Road Shanklin Isle of Wight PO37 6RQ Lead Inspector Liz Normanton Unannounced 21st June 2005 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. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Plean Dene Address 2 Luccombe Road Shanklin, Isle of Wight, PO37 6RQ 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) 01983 866015 01983 868267 Islecare 97 Care Home 15 Category(ies) of Learning Disability (15), Learning Disability over registration, with number 65 years of age (3). of places Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: This home temporarily has a service user under the age of 18 years of age. Date of last inspection 19/10/2004 Brief Description of the Service: Plean Dene is a home providing care and accommodation for up to fifteen people with a learning disability. It is managed by Amanda Minshull on behalf of Islecare 97 Ltd. The home is a large detached two storey property set in its own grounds with a car park to the front. The town of Shanklin with its shops and amenities is a few minutes walk away. A main bus service close to the home affords access to the towns of Ventnor and Shanklin. There is a good sized garden and patio to the rear, which are available for use by the residents. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of the inspection year and was unannounced. The inspection took place in the early part of the week and the inspector was at the home from mid morning until mid afternoon. When the inspector arrived there were a number of service users who were sitting in the communal lounge and one resident was finishing off breakfast. Three service users were out at day centre services. During the course of the day the inspector observed service users accessing areas of the home and garden freely as they chose. A barbeque lunch had been planned as one the day’s activities. Due to the ground surface in the garden being uneven walking towards the BBQ the staff had to get the service users’ lunch on their behalf. There is currently a problem with moles and there were a great number of mole hills in the lawn area. The manager stated that the matter is being dealt with. The inspector noted that everybody had a good range of food on their plates including salad. Cold drinks were also provided. Staff sat outside with service users and ate lunch together. Two service users chose to eat their lunch in the dining room and a member of staff sat with them. The inspector undertook a partial tour of the home and found all areas to be clean, tidy and free from offensive odours. The home has a separate kitchen unit, which could be used by service users to learn basic life skills this was not being used in this capacity at the time of the inspection but was being used as a storage area for the provisions that have been bought for the service users’ holiday. The inspector interviewed three staff and had a general discussion about care in the home with two service users. There were no visitors at the home at the time of the inspection. What the service does well: The home provides a safe, warm, secure environment for the service users to live in which has comfortable furniture and well decorated surroundings. Service users benefit from a well trained staff team who are able to understand their methods of communication. Although the home is situated in a quiet suburban residential area staff endeavour to take service users out and integrate them in to the local and community. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 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 Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 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) Four of the above standards were assessed at the previous inspection and were met. EVIDENCE: Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 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) 6,7,8,9 The service users have learning disabilities and communication difficulties, which may impair their ability to understand the purpose of their care plns and the role of the key-worker. Some will have a clearer understanding than others. The majority of the service users are unable to participate in the day to day running of the home but are able to make choices about how they wish to spend their time, what they would like at meal times and what to wear. Service users are able to take risks and are supported by staff. One service user lives semi-independently from the rest of the group and is supported to be as independent as possible. EVIDENCE: The inspector viewed two service user care plans and found them to have all the necessary information required for staff to understand each individual’s care needs. The care plans also incorporated risk assessments. The manager informed the inspector that care plans would be completed by herself or the deputy manager and that this would be completed prior to admission where possible. The care plans are generated from an initial assessment and residents and family would be invited to take part in drawing up the plan. The home operates a key worker system and the key-workers review care plans monthly and update them as required. The manager informed the Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 Page 10 inspector that an annual meeting is held with the service user and care manager to overview the placement and the care plan would also be revised at this time. Service users were observed making choices about how they spend their time, one person spent time outside sunbathing, another was engaged in knitting, whilst others watched television and listened to music. Staff have made service users aware of advocacy services. One service user who has no family has an independent advocate and another has chosen not to have an advocate. A member of staff confirmed that an advocate comes to the home. The manager informed the inspector that one service user is in control of their finances and that she is appointee for the others. Staff support service users to spend their personal allowance. The inspector saw records of the incoming and outgoing of finances. The manager stated that service users are allowed to take risks, one service user goes out on their bicycle, manages their own finances and visits the local pub, and the inspector saw evidence of risk assessments on the care plans. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 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) 11,12,13,14,15,16 The majority of the service users are dependent upon support from staff, with only one living semi-independently. Service users are able to take part in activities which are appropriate to their age group, peer group and cultural background. The staff ensure that service users access the local community. Leisure facilities are provided within the home. Service users can choose to go on holiday. Staff respect the rights of service users and treat them with dignity. EVIDENCE: The inspector did not meet with the service user living in the flat. Eight service users living in the main body of the home each have an individual bedroom, these do not have locks, the manager was seen to knock on doors before entering rooms. Eight service users are supported to attend day centre services, they are transported in the home car. Three people were attending the day centre at the time of the inspection. When not at the day centre service users can choose how to spend their free time. The inspector observed individuals relaxing in the lounge, sitting in the garden, knitting or spending time in their own rooms. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 Page 12 Nobody at the home is currently in need of specialist therapy/treatments, however an aromatherapist visits the home weekly to provide aromatherapy massage to those who want to participate. The manager stated that she would seek advice from the Learning Disability team if service users’ health needs changed and they required specialist support. Staff confirmed that service users go out for pub meals, visit garden centres, cinema, pantomimes attend band concerts and carnivals, they also go for walks in Shanklin. Service users are also invited to coffee mornings and parties at other Islecare homes, which they enjoy. Staff also arrange day trips for service users in the summer time. Several service users attend St Johns Club once a week. Within the home leisure activities are provided, jigsaw puzzles, musical instruments, skittles, television, books, magazines. One service user likes to clean their bedroom and also takes part in other household tasks, she also likes to help other service users. The inspector observed a service user receiving mail, the manager stated that most service users open their own mail but some need assistance. The manager informed the inspector that all the service users are registered to vote. The inspector viewed the staff roster, which demonstrated that sufficient staff are on duty to enable them to spend individual time with service users. The inspector observed staff offering one-to-one support to service users throughout the day. The staff team reflect the racial and cultural background of the service users. There are plans to take five service users on holiday to the New Forest this summer time, from Monday to Friday, five staff will accompany them and they will be travelling in the home’s vehicles. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 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) 20 Medication is administered by the staff team as service users are not able to self administer. The home has policies and procedures in place to protect service users. EVIDENCE: The manager informed the inspector that only senior staff administer medication and that they have all completed the Advanced BTEC Medicine, Principles of Administration & Control course. The inspector viewed the home’s medication policy and procedures and examined the MARs charts and saw that they were signed and dated. There is nobody currently taking controlled medication. Service users are not able to give written consent but make the choice to take or refuse their medication, returns are recorded and sent to the chemist. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 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 standard(s) 22 and 23 There is every likelihood that the service users do not understand the concept of complaining, as there were no recorded complaints for a number of years. The home has policies and procedures in place to protect service users from harm. EVIDENCE: The inspector viewed the home’s complaints procedure which is not currently available in a format that is meaningful to service users. The inspector observed positive interaction between the staff and service users and staff stated that they knew how to ascertain people’s views and wishes through reading body language and facial gestures. This method of communication however has its limitations and relates only to choice and does not promote the opportunity to complain about any aspects of the service. The inspector talked privately with two service users and it was evident from these discussions that the service users were not aware of the meaning of the word complaint. The manager was well aware of the complaints procedure and knew that all complaints had to be taken seriously and to be acted upon in 28 days. There have been no complaints recorded for many years either by service users or their relatives. Islecare 97’ Ltd provide the home with adult abuse policies and procedures. The manager has been trained in how to recognise abuse and this area is touched upon in the NVQ training a number of staff have completed NVQ level 2 in care. There are plans to offer staff adult abuse training in November 2005. The home has a whistle blowing policy for staff if they suspect that a colleague or management are abusing service users. The manager informed the Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 Page 15 inspector that there have been no allegations. The manager is responsible for service users’ personal allowances, money is kept safe and all financial transactions are recorded. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 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) 30 Service users benefit from living in a home which is kept clean and free from offensive odours. EVIDENCE: The inspector undertook a full tour of the property including the gardens. Every area was found to be clean, tidy and free from offensive odours. The laundry facilities are situated away from food preparation/storage areas, the floor was found to be covered with an impermeable surface. There was a hand basin situated in the laundry, and rubber gloves were also provided. Service users’ clothing is kept in individual baskets to prevent any spread of possible infection. The home has two washing machines, both wash on automatic programmes and meet the appropriate temperature for washing foul laundry. Both machines also have a sluice cycle. All substances hazardous to health are kept securely locked in the COSHH cupboard. The home has COSHH policies and procedures for staff to follow. The manager informed the inspector that the staff have had relevant training in Health and Safety, Health and Hygiene, Food Hygiene and Infection Control. The staff confirmed that they had been trained in these areas. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 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) 33,34,35, The home employs an experienced staff team and staff turnover is low. Service users are supported and protected by the home’s recruitment policies and procedures. The individual needs of the service users are met by a staff team who have relevant training in the area of learning disability. EVIDENCE: Islecare 97’ Ltd employ twenty staff at the home, which includes management. The staffing structure is made up of a manager, deputy manager, two senior staff and four stand-in seniors, and care assistants. The inspector viewed the staff roster and found that five staff are on duty in the morning, six in the afternoon and two at night during the week, and that there are six staff on am and pm at the weekend to support people in choices. The inspector observed that the numbers of staff on duty tallied with the roster. The manager is recently new to the home but has experience of learning disability and has managed homes in the past. Through discussion, and a review of records, the inspector concluded that the staff team is well established. The inspector spoke with three staff who had all worked at the home for over eighteen months. There are five male staff members to meet the needs of the male service users. Staff were observed communicating with service users and understood their needs. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 Page 18 Islecare 97’ Ltd is an equal opportunity employer and provides the home with recruitment policies and procedures. The inspector viewed staff files and found them to contain two references. The manager stated that Islecare does not employ anybody until POVA first checks are received, there was no evidence in staff files of Protection of Vulnerable Adults or Criminal Record Bureau checks as these are kept at the head office. Records need to be kept in the home. Service users are not currently participating in the recruitment of staff, however the manager stated that she and Islecare are looking into this for the future. On commencement of employment staff are given a job description and a copy of the General Social Care Council Code of Conduct booklet. The manager stated that there is a twenty-two week probationary period. Two staff employed within the past eighteen months confirmed that they had received an induction. The manager informed the inspector that Islecare has a training budget, which is linked to service users’ needs. The home has a staff training and development plan. All staff have refresher training annually in the areas of Food Hygiene, Health and Safety/Hygiene, Moving and Handling, First Aid, Fire Safety. The above is mandatory training and is part of the induction programme. All staff receive, equal opportunities training and learning disability training as part of their induction. The manager assesses training needs through supervision, yearly appraisals and staff meetings, and has produced a training calendar to ensure that training is ongoing. Staff confirmed that they receive training. Eighteen staff, including management, have undertaken Learning Disability Award Framework (LDAF) induction training, the manager has completed the LDAF foundation course and six staff are currently working towards completing the LDAF foundation course. The manager has completed NVQ level 4 in care and Registered Managers Award. Seven staff have completed NVQ level 2 in care, and eight have almost completed the course. Three staff have completed NVQ level 3 in care. Two staff have had Autism training. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 Page 19 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) 42 Service users benefit from safe working practices within the home. EVIDENCE: The home provides policies and procedures for safe working practices. The manager ensures that staff comply with safe working practices through observation/guidance and staff meetings, and through supervision. The inspector saw written evidence that gas and electrical services are serviced as required. Hazardous substances were locked away in the COSHH cupboard, which is housed in the laundry. There are safety notices posted around the building and health and safety information is also on display. All staff have received the relevant training in safe working practices. The inspector saw evidence that the fire alarms are tested weekly. The hot water to bathrooms and bedroom hand-basins is thermostatically controlled. The home has a magnetic door fitted at the front and a security light fitted to the patio, all windows and entrances/exits are checked at night. The manager has completed an generic risk assessment of all areas that could be a risk to service users and staff. The home has an accident book for staff and a separate incident record sheet for service users. Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 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 x x x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 2 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x x 3 2 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Plean Dene Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 Page 21 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 YA8 Regulation 12 (2) Requirement The manager to consider new opportunities for service users to participate in the day to day running of the home and recruitment and selection. The manager to develop a complaints procedure in an appropriate format for service users. Evidence of POVA first checks and CRBs must be available in the home for inspection. Timescale for action 31-08-05 2. YA22 22 (2) 31-08-05 3. YA34 19 Sch 2 31-08-05 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 OP30 Good Practice Recommendations Autism training to be provided to all staff Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Mill Court Furrlongs Newport Isle of Wight, PO30 2AA 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 Plean Dene H55_H04_S12523_Plean Dene_V218547_070605 Stage 4.doc Version 1.30 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. 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