Inspection on 27/10/05 for Plean Dene

This inspection was carried out on 27th October 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 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 21/06/05

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 Inspection 27th October 2005 09:55 Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 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 Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 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. Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Plean Dene Address 2 Luccombe Road Shanklin Isle Of Wight PO37 6RQ 01983 866015 01983 868267 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) Islecare `97 Limited Mrs Amanda Minshull Care Home 15 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (3) of places Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home temporarily has a service user under the age of 18 years. Date of last inspection 21st June 2005 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 goodsized garden and patio to the rear, which are available for use by the residents. Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the second in the inspection year. The inspection took place on 27th October 2005 and the inspector was at the home for six hours. The inspector focussed the inspection on the core standards not audited at the last inspection and also assessed a number of non-core standards. Particular attention was paid to the premises, which were found in the main to be in good repair. The inspector felt that the colour scheme in the lounge was vibrant and stimulating and did not provide a relaxing environment for the residents. The curtains were heavily patterned and also very bright and stimulating. There was some damage to paintwork in the living room on the skirting and the ceiling wallpaper is peeling off in small areas. The lighting in the living room was harsh, as all light bulbs did not have shades. The dining area is well decorated and was furnished with sturdy solid wood tables and chairs. The lighting in the dining room was very dim and staff commented that it was difficult for service users with visual impairment to see. The en-suite in the independent flat is being refurbished. All residents’ bedrooms were decorated to a good standard and were personalised. The kitchen was clean and hygienic and the chef was found to be enthusiastic and knew the residents’ tastes in food and catered for them accordingly. Support staff were observed positively interacting with the service users throughout the day. The staff team are experienced in caring for adults with learning disabilities and understand challenging behaviours. The inspector observed that services users were exercising their right to choice throughout the day with a number of people having a lie-in whilst others were up and about and sitting in the lounge. The inspector had full access to the home and spoke with service users and staff and spent time discussing the home with the manager. Staff files, residents’ records and policies and procedures were viewed during the inspection. What the service does well: What has improved since the last inspection? Islecare ‘97 Ltd have reviewed their recruitment policies and procedures which will lead to individual homes having the responsibility for recruitment. The service users will now meet all potential employees, and their views will be Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 6 taken into consideration. Work is being undertaken to improve the service users’ complaints guidelines. Evidence that Criminal Record Bureau checks have been undertaken in the recruitment process was available. 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 DS0000012523.V251412.R01.S.doc Version 5.0 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 Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 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): 1,2, 3 and 5 There is written information about the home to enable service users and their representatives to make an informed choice about whether the home would be suitable to meet their needs, however this needed updating. The needs and aspirations of prospective service users are assessed prior to admission. The home meets the needs of the service users. The residents were not in receipt of terms and conditions of their placement. EVIDENCE: The home’s manager has reviewed the statement of purpose and is undertaking to make amendments. The current document does not include contract terms and conditions or details of how to make a complaint. The inspector viewed four service user files and found them to contain comprehensive assessments of need. An individual care plan had been drawn up using the information from the assessment. Family members are invited to attend annual reviews. Each resident has an individual care plan, which informs support staff of their care needs. The inspector observed support staff positively interacting with residents. Each resident also has an independent health action plan. Specialist services are provided by the district nurse and learning disability nurse. The home liaises with care managers and annual reviews are undertaken. Six support staff have completed Learning Disability Award Framework (LDAF) training at induction and foundation level, thirteen have Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 9 completed the induction level. Over 50 of the support team have National Vocational Qualification NVQ in care at level 2 or above. In discussion with the manager it was stated that two service users have independent advocates. One resident was offered an advocate and refused. Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 10 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): Four of the above standards were audited at the last inspection and were met. EVIDENCE: Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 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): 17 Service users are offered a wide range of food choices and enjoy their meals. EVIDENCE: The inspector spoke with the chef who clearly knew the food preferences of residents and took these into consideration when planning menus. The home has a six weekly menu. Service users are offered three meals a day and snacks are available between meals. Meals are usually had in the dining room, however service users can choose where they would like to eat. The inspector observed service users having their lunchtime meal, and those that required assistance/supervision were supported by staff. The meal was nutritious and the portion size was good. Feedback comment cards from two service users indicated that they liked the food. Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 12 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): 18 and 19 The support staff provide personal care/support to residents in the way they prefer and require. The home meets the healthcare needs of the service users. EVIDENCE: The inspector observed residents being supported throughout the day and noted that care was provided in the privacy of bedrooms and bathrooms. Each resident had an individual care plan. The home has a mixed gender staff team which enables residents to have intimate care provided by a person of the same gender if they wish. Residents are able to decide what time they get up and go to bed, evidence of this was recorded in the information book. Residents’ individual personalities were reflected in their appearance. The home provides technical aids and equipment to enable service users to get safely in and out of the bath. The manager ensures that each service user has a designated key-worker who can provide consistency and continuity. The inspector examined four service user files and found them to contain health action plans. There was evidence that residents are having regular eye tests, dental checks, hearing tests, appointments. The chiropodist visits the home every six weeks and a number of service users visit the Lake clinic for chiropody. There was evidence of monitoring individuals’ health records of hospital appointments. Residents are all registered with the local general Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 13 practice. The district nurse provides a continence service on a regular basis. The home consults with the Learning Disability team for support and advice. Two service users commented that they were happy with their care. Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 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): The above standards were audited at the previous inspection, one was met and one was almost met. EVIDENCE: Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 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, 25, 26, 27, 28 and 29 Overall the home offers service users a comfortable, safe environment, however the sitting room was seen to be in need of redecoration. Individual bedrooms suited the needs and lifestyles of individual residents. There are sufficient toilet/bathroom facilities within the home. The home’s shared spaces complement the service users’ individual rooms. The home provides service users with equipment to maximise their independence. EVIDENCE: The sitting room was found to have curtains, which have in part been pulled off the curtain poles and looked untidy. In discussion with support staff the reason for this is due to a number of residents’ behavioural difficulties. The wallpapered ceiling is peeling away in a number of areas. Paintwork on the skirting boards was chipped. The home has two vehicles, which are used to transport service users to day-centre services, doctors’ appointments, outings etc. The premises are in keeping with other properties in the area. There is ramped access to the front door and from the living room. The lighting in the living room is harsh with uncovered bulbs on the wall lights and ceiling lights. The lighting in the dining room was described by staff as very dim and that it was dingy at night. Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 16 There are fourteen individual bedrooms, each service user has their own room. The inspector viewed thirteen of the bedrooms and found them to be unique and reflected the individual personalities of the service users. One service user stated she was very happy with her bedroom. All the bedrooms are fitted with locks, however the service users are not able to take responsibility for key holding. The home is fitted with double-glazing PVC windows and these are fitted with window restrictors. All bedrooms are fitted with washbasins. There are two bathroom/toilets and a w/c on the first floor. There is a bathroom/toilet on the ground floor. The independent flat is fitted with a shower–room and separate w/c. All bathrooms and toilets are fitted with locks. In addition to their individual bedrooms the service users share a large sitting room, dining room, quiet room/kitchenette and extensive gardens. There is ramped access to the front and side of the home. The ground floor bathroom is fitted with a specialist bath. Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 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 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): 31,32 and 36 The support staff are aware of their roles and responsibilities within the home. The service users are well cared for by competent and qualified support staff. The manager provides supervision and support and leads by example. EVIDENCE: Support staff have written information provided for them by way of a notice board, which highlights daily duties. There was a communication book in place and a handover book to enable support staff changing shifts share information. The support staff were aware of the service users’ needs by way of the care plans. Support staff were observed in their daily duties and were seen to be proficient at meeting the service users needs and day-to-day running of the home. Islecare ‘97 Ltd provide support staff with a job description and code of conduct. Supervision enables support staff to discuss training needs. Six support staff have completed the Learning Disability Award (LDAF) framework at Induction and Foundation level. Thirteen support staff have completed LADF at induction level. Over 50 of the staff team have completed National Vocational Qualification (NVQ) in care at level 2. All staff have received mandatory training, which includes health & hygiene, food safety etc. The manager stated that she and the deputy provide formal supervision at least four times a year with support staff being able to ask for additional sessions if required. Four staff files were viewed by the inspector, who found them to contain recorded supervision notes and identified training needs. The Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 18 yearly appraisal was overdue. All staff are in receipt of a staff handbook, which provides details of grievance and disciplinary procedures. Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40 and 41 The manager runs the home very well and service users benefit from this. The majority of service users have limited cognitive abilities and would not understand the concept of Quality Assurance, however the home does endeavour to engage in obtaining service users’ views. The service users’ rights and best interests are safeguarded. Records within the home are in general kept up to date and stored appropriately. EVIDENCE: The manager is well qualified to run the home and has completed NVQ level 4 and Registered Managers award. The manager stated that Islecare ‘97 Ltd have provided her with a job description. The manager is committed to training and development and is planning to undertake an Intensive Interactive Techniques (communication) in the near future. The manager is fully aware of her responsibilities in running the home and managing staff and has begun to implement changes. In discussion with the manager it was stated that service users’ meetings are held quarterly. The service users’ meetings are co-ordinated by a designated Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 20 member of staff. There was no evidence of recorded minute taking of the meetings available for inspection. The home receives feedback from relatives and stakeholders at service users’ reviews. Islecare ‘97 Ltd have developed an annual service user questionnaire with Makaton Symbols. Islecare ‘97 Ltd provide the home with policies and procedures and also purchase policies and procedures which are then implemented into the home’s practices. Policies and procedures are regularly reviewed and updated. Policies and procedures are kept in the office and are available to staff. When changes are made to policies and procedures the manager or deputy inform staff and advise them to read and familiarise themselves with the changes. The records required for regulation purposes are kept up to date and are kept secure. The service users would not have the capacity to read the contents of any records kept about them. Plean Dene DS0000012523.V251412.R01.S.doc Version 5.0 Page 21 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 3 x 1 Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 3 x x x 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Plean Dene Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 3 3 x x DS0000012523.V251412.R01.S.doc Version 5.0 Page 22 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. 2. 3. Standard YA 1 YA 1 & YA5 YA 24 Regulation 4 (1) (c) 5 (1) (b) 23 Requirement The statement of purpose must include details of the complaints procedure. All residents must be supplied with a terms and conditions of the placement. Repairs to damaged decorations in the living room to be undertaken as part of ongoing refurbishment programme. Plan of action to be submitted to CSCI. Timescale for action 31/12/05 31/12/05 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 24 Good Practice Recommendations Consider redecorating the living room in a calmer colour scheme to provide a more relaxing environment to residents in particular those who are on the autistic spectrum. Give consideration to provide adequate/appropriate lighting in the shared areas. DS0000012523.V251412.R01.S.doc Version 5.0 Page 23 2 24 Plean Dene Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW 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 DS0000012523.V251412.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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