Inspection on 25/10/06 for Sandhills

This inspection was carried out on 25th October 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Sandhills 03/02/06

Sandhills 24/10/05

Sandhills 21/03/05

Sandhills 07/02/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Sandhills Lower Road Stalbridge Sturminster Newton Dorset DT10 2NJ Lead Inspector Marion Hurley Key Announced Inspection 25th October 2006 10:00 Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 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 Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 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. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandhills Address Lower Road Stalbridge Sturminster Newton Dorset DT10 2NJ 01963 362247 01305 252001 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) Dorset Residential Homes Mrs Margaret Cooper Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 2006 Brief Description of the Service: Sandhills is located on the outskirts of Stalbridge in North Dorset, and is a registered care home providing nursing and personal care for up to 10 people with learning disabilities. One of the bedrooms is made available for short stay/ respite accommodation. The home is managed by Dorset Residential Homes, a registered charitable trust that operates a number of care services across Dorset. The home is a detached property that has been extended and converted to meet the needs of service users. The communal areas comprise a lounge, separate dining room, conservatory and kitchen. There is small office on the first floor for staff. Detailed information about the services provided at Sandhills can be found in the home’s Statement of Purpose / Service User Guide. Copies of these documents and the latest CSCI inspection reports are available directly from the home or from Dorset Residential Homes Head office in Dorchester. Current fees are from £1134. 00 but may vary according to an individual’s assessed needs and abilities. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection started at 10:00 and lasted for just over four hours. The inspection involved talking to the registered manager, the Home’s Liaison Officer and three members of staff. The process also included observing staff working with two residents, reading care plans, policies and records specifically related to health and safety practices and checking the administration and recording of medication. The visit also included a tour of the premises. There was considerable evidence that the home continues to provide a good quality service to meet the various and at times complex needs of each resident. What the service does well: There is a skilled and experienced management team, which provides excellent direction and support to an enthusiastic staff team, who clearly enjoy their work at the home and have a good relationship with the residents. The staff are knowledgeable about the needs and support required for each resident. The home has a relaxed and friendly atmosphere and it is evident that the philosophy at Sandhills is to create a “home” for the people who live there. Meals are varied and balanced and well presented offering both choice and variety. Residents access a range of activities, both inside the home and outside the home, including going to Church, local pubs, theatre, and trips out to local attractions and shopping trips. Residents are supported to play an active role in the life of their community, by participating in a variety of events and activities. Residents are supported with their personal routines as necessary. Bedrooms have been personalised to reflect individual tastes and preferences. Positive feedback was received from other stakeholders including the local Community Team and GP, who stated, “staff are excellent”. Feedback from a relative stated “ staff appear wonderfully kind, patient and understanding.” The service is good at reviewing its own practice to ensure it can identify and meet any changing needs of the residents. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 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 Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service (Dorset Residential Homes) has a comprehensive pre-admissions policy and process, which enables the service to identify the needs of prospective service users and for the service users to visit the home prior to moving in. EVIDENCE: Whilst no new service users have moved into the home for a number of years, the manager was able to describe the policy and procedure for assessing prospective service users. The policy/ procedures states that all prospective service users should be given the opportunity to visit the home on several occasions prior to choosing to move in. The manager said that initial visits would include the prospective service user meeting the people already living in the home, meeting the staff and perhaps staying for a meal. The manager advised that the prospective service user could be offered the chance to stay overnight, if they wished and if it met their needs, prior to making a decision to move in. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs and their required support are clearly documented in their individual plans. Residents are consulted about all aspects of the home and are supported to make their own decisions within their own capabilities and comprehension. Clearly assessed and managed risks enable residents to undertake a wide range of activities. EVIDENCE: Individual (care) plans contained comprehensive information about the residents. The plans had clearly assessed needs, background information and goals. There were clearly stated support guidelines to enable staff to meet the needs of each resident. The plans contained information about residents’ likes and dislikes, family and friends, communication, daily routines and activities. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 10 There was documentary evidence that the care plans had been regularly reviewed and updated as necessary, to reflect any change in needs. The care plans reflected the individual needs of each resident and contained specific guidelines to enable staff to effectively work with each resident to manage and enhance their quality of life. Of note was evidence that one care plan had been reviewed and updated to reflect the changes in approach by staff to work more effectively with one particular individual. Staff practises observed throughout the inspection demonstrated a good understanding of the residents and their needs. The interaction between staff and residents was positive and it was evident residents were being encouraged and supported to make their own decisions and choices e.g. choosing activities and the food they wanted to eat. Each resident has an allocated named nurse and key worker, which ensures the plans, are kept up to date. There was documentary evidence of risk assessments and management plans to enable residents to undertake a wide range of activities in the home and in the community. Risk assessments had been regularly reviewed and updated as necessary. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to lead healthy and fulfilling lives. Residents play an active and fulfilling role in the life of their community. They are supported to maintain positive relationships with family and friends. The ethos of the home promotes the rights of resident to make choices in all aspects of their lives. Residents’ benefit from a range of varied and balanced meals. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 12 EVIDENCE: The residents play an active role in their local community, including accessing all local amenities and facilities as well as working with volunteers and friends who support them in their lives. Some residents had been away on holiday this year whilst others have enjoyed a series of day trips. The manager and staff explained how they encourage each person to select their own preferred holiday/ activities and where necessary do this with the aid of pictures and photographs. The manager reported that residents are supported by staff to keep in regular contact with their families and friends. Feedback from relative comment cards said that the manager and staff “are always helpful and approachable and provided very good care in the home”. Another relative of a resident praised the quality of care provided by the manager and the staff. It was confirmed that residents are supported by staff to visit their family and friends as well as to keep in contact via the phone, Internet and letters. The residents/home had a very successful barbecue in the summer inviting many families and friends. Staff were observed treating residents with dignity and respect. Care plans indicated the individuals’ chosen form of address. Staff spoken with were very positive in their approach to working with the residents and were sensitive and supportive of the individual needs and preferences of each resident. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff provide sensitive and dignified support to meet the individual needs and preferences of the residents. Residents are supported to access a range of health services to meet their physical and emotional needs. The health and well being of residents is safe–guarded by robust policies and medication being stored, dispensed and recorded appropriately. EVIDENCE: Staff were observed providing sensitive and dignified care to the residents. There was documentary evidence that service users are supported to access a range of health care services to meet their specific needs. All residents are registered with a local General Practitioner and are supported to access any specific support as required. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 14 The management and staff team described how they endeavour to meet the complex and varied needs of the residents. Medication is kept securely in the home and is dispensed by staff who have completed a training course in the administration of medication. The medication files contained a photograph of each resident, with clear guidelines and criteria for dispensing of all the medication. All medication had been dispensed and signed accurately. There is a weekly check to ensure the accuracy of the dispensing and recording of medication. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to raise concerns and complaints. Residents are protected from abuse by robust policies and procedures for the recruitment of staff and the staff receiving appropriate training. EVIDENCE: The service has a complaints book though no complaints have been received since the last inspection. Staff confirmed residents are supported to raise any issues or concerns they may have, either in one to one time or through their relatives and friends. There was evidence that staff have either completed or are scheduled to complete a refresher-training course in adult protection. The manager and staff were able to describe how any potential adult protection issues would be raised and dealt with. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a relaxed and friendly environment that is kept in good decorative order and provides offers sufficient communal space. There are sufficient bathroom and toilet facilities that meet the needs of the residents. The home is kept clean and tidy. EVIDENCE: The home offers a homely, relaxed and well-maintained environment. There is a good-sized kitchen, dining room and large lounge and separate conservatory. There are sufficient toilet and bathroom facilities to meet the needs of the residents. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 17 There was evidence of on going maintenance including the redecoration of some rooms and communal areas. Residents are able to decorate their rooms to suit their own needs and tastes and those viewed were decorated with personal pictures, photographs, ornaments and possessions. All the bedrooms were homely, comfortable and met the needs of the individual residents. Residents are able to spend time in either their own bedrooms, or in any of the communal rooms. Adaptations and aids are provided according to the assessed needs to the individual residents. Staff from the home work closely with the Community Occupational Therapist and Physiotherapist to ensure the correct aids and adaptations are provided to meet the individual needs of the residents where required. The home was clean and tidy at the time of this announced inspection despite redecoration work being undertaken at the time of the visit. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a skilled staff team who continue to work hard to meet the needs of the residents. The staff team are supported to provide consistent care and meet the needs of the residents and benefit from regular supervision and staff meetings. EVIDENCE: There is a skilled, experienced and caring staff team, who provide flexible and innovative support to meet the needs of the residents. Staff were able to describe in detail their roles and responsibilities and those of their colleagues. Staff had an in-depth knowledge and understanding of the individual needs of residents and how these were met. There is regular discussion and review in the team and at staff meetings of the way the service operates and meets the changing needs of residents. The staff team have worked hard to review and change the support provided to one resident. There was documentary evidence of the manager and staff adopting Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 19 a different approach in the support they provided to one specific resident, which had been successful in enabling the resident to establish a more comfortable daily routine. The manager described the close working relationship with colleagues from other professions to establish this new approach of supporting this person. Staffing levels are flexible to ensure residents are supported to undertake a wide range of activities throughout the week and at weekends. Staff holidays and sickness are covered by relief/bank staff who regularly work in the home and are therefore able to provide consistency of care to residents. Dorset Residential Homes has robust employment procedures. When new staff are employed staff from the organisation’s main office obtain all the relevant information and checks on the new staff and then write confirming this information to the home’s manager for their own records. Staff confirmed that they receive regular supervision and attend staff meetings. Staff also said that they felt well supported by the management team and could raise any issues or concerns they might have. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sandhills’ benefits from a skilled and experienced manager who provides clear direction and support to enable the staff to provide good quality care to the residents. The views and rights of the residents underpin the ethos and development in the home. Up to date policies and records of health and safety checks help to protect the residents. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 21 EVIDENCE: The home is effectively run by a skilled and experienced manager, who supported by the deputy manager provides a clear sense of direction and values. The manager ensures the home continues to provide good quality care to the residents, and regularly reviews practice to identify and meet any changes in needs. Written feedback received in the comment cards and the staff spoken with all spoke highly of the manager, who was described as being professional, approachable, supportive and knowledgeable. The manager and deputy on duty throughout the inspection visit demonstrated an in-depth knowledge of the residents, as well as a flexible and innovative approach to ensure the residents are supported to undertake a wide range of meaningful and fulfilling activities. The staff team have “an away day” once a year, where they review practice and set goals for the coming year. Staff from the organisations main office undertake monthly monitoring visits, in conjunction with the homes own monitoring checklist. A sample of policies and records were found to be in place and up to date. There was evidence of regular reviews of the policies and procedures by the organisation. There is a range of regular health and safety checks within the service, including weekly fire system checks, regular checks on the vehicles and environmental checks. Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 22 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 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 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 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 x Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sandhills DS0000020490.V305888.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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