Inspection on 27/06/06 for St David`s APL

This inspection was carried out on 27th June 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St David`s APL 25/06/08

St David`s APL 26/01/06

St David`s APL 04/08/05

St David`s APL 18/01/05

St David`s APL 27/07/04

St David`s APL 08/03/04

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 St David`s APL 11 Barton Villas Dawlish Devon EX7 9QJ Lead Inspector James Rose Unannounced Inspection 27 and 28th June 2006 9:00 th St David`s APL DS0000055164.V296746.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 St David`s APL DS0000055164.V296746.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. St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St David`s APL Address 11 Barton Villas Dawlish Devon EX7 9QJ 01626 865597 01626 866496 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) David Hardee To be arranged Care Home 9 Category(ies) of Learning disability (6), Mental disorder, registration, with number excluding learning disability or dementia (1), of places Mental Disorder, excluding learning disability or dementia - over 65 years of age (2) St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The lower ground floor to be specifically for three named Service Users with Mental Disorder category only 26th January 2006 Date of last inspection Brief Description of the Service: St Davids cares for 3 specific residents with mental health problems two of whom are aged over 65, and up to six residents with learning disabilities aged 18 - 65. The Home is a large semi-detached house in a residential area of Dawlish within walking distance of the hospital, shops, amenities, bus and train services. On the ground floor is a self-contained flat for three older residents with mental health needs. These residents were living at the home when it was previously registered solely for people with mental health needs. The first and second floor is registered for up to 6 residents with learning disabilities. The first floor has an open plan kitchen and dining room, a lounge, and office. All the bedrooms are on the second floor. Five are en-suite and the sixth has sole use of a separate toilet and bathroom. The laundry facilities are in a separate building just outside the ground floor flat. There is a caravan in the back garden, which is lived in by a person with a learning disability who is being supported by the staff at St. Davids. St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 11 hours in June 2006. A complete tour of the home was undertaken and samples of the care records were examined. Residents were consulted individually for their views of life at St Davids and the service provided and two members of the staff team were also interviewed individually in private. Evidence was also obtained from visitors to the home and healthcare professionals. The way care was delivered was observed and the registered manager assisted throughout the inspection process. What the service does well: What has improved since the last inspection? The proprietors have a refurbishment programme running at St Davids and a substantial investment has been made since the last inspection to redecorate the interior of the building and to provide appropriate floor covering. The requirements raised in the last report have been satisfied and the recommendations have also been put in place. St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 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. St David`s APL DS0000055164.V296746.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 St David`s APL DS0000055164.V296746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The performance of the home in this group is good. Detailed comprehensive assessments are in place for each resident in the home. EVIDENCE: Detailed assessments are undertaken by the home of all the needs of a prospective resident this includes the person’s individual aspirations. All the residents consulted during the inspection process advised that all their needs were met at the home and they were able to undertake the activities that they liked on an individual basis. St David`s APL DS0000055164.V296746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 The performance in this group is good. Comprehensive service user plans were in place that had been agreed with the individual concerned and regular reviews were undertaken. The risk assessment processes undertaken needed to be developed further to ensure all hazards were analysed. EVIDENCE: Residents were consulted about their individual care plans and were involved in the review process that was undertaken regularly in the home. A range of activities were available and the person concerned was enabled to make their own choices about what they would like to do. Any limitations placed on a resident was addressed through the assessment process involving the service users and integrated into the individual care plan. Support was provided by the home to enable residents to take reasonable risks as part of an individual lifestyle. However, the risk assessments undertaken needed to be developed further to include all risks, a requirement has been raised with the timescale for completion agreed with the management of the home to ensure residents are safe. St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 10 St David`s APL DS0000055164.V296746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 The performance in this group is good. The home enables residents to take part in appropriate activities and full use is made of community facilities. Service users are encouraged to maintain family links and friendships. Residents’ rights are respected and their privacy is maintained. The meals provided at the home are nutritious, varied and balanced and are enjoyed by the residents. EVIDENCE: A range of fulfilling and valued activities are available for residents and they make their own choices about what they would like to take part in. These choices are meaningful and are not undertaken in a group. One resident remarked, “I like it here and I choose the things I want to do” this comment was made individually in private and was clearly meant by the service user who made it. Full use is made of the facilities in the local community, residents use the shops and visits are made to the theatre and cinema. Visits to the local pubs for meals and drinks are a particular favourite with residents. Some of the other activities available are gardening, walking, horse riding and stable St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 12 management, climbing and abseiling, canoeing, boating and caving and many more. Trips out are also undertaken to leisure venues such as Longleat, Woodlands Park etc. Visitors are always made welcome in the home and an unrestricted visiting policy and procedure is in place. Residents are encouraged to maintain their relationships with family and friends subject to agreed restrictions in the individual care plan and some residents make regular visits to their family home. Residents’ rights are respected and their privacy is seen as important and is maintained by the staff team. A healthy diet is provided at the home, the meals are varied, balanced and nutritious. All the residents consulted advised that they liked the food served and did not wish to make any suggestions of foods they would like added to the menu. St David`s APL DS0000055164.V296746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 The performance in this group is good. Personal support is provided to residents in the way that they like and their physical and emotional needs are met. The administration of medication was generally appropriate but there were some deficits. EVIDENCE: All the residents consulted during the inspection process advised that the support provided by the home was undertaken in a way they were comfortable with. This was also supported by observations made at the time, appropriate banter was over heard between residents and staff and a relaxed atmosphere was apparent. Residents are respected and supported to make their own decisions and live as independent a lifestyle as possible. Appropriate access is provided to healthcare professionals when required and emotional needs are well known and met by the service provided at St Davids. The local surgery was contacted as part of the inspection and it was confirmed that the home has their confidence. Residents are able to self medicate subject to a risk assessed approach to ensure this is appropriate. St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 14 The recordings of the administration of medications undertaken by the home were examined, some deficits were apparent in the issue record and these are being investigated by the registered manager. Medication was booked in when received and all returns made to the pharmacist were also recorded appropriately. Medication was stored under appropriate secure conditions, which ensured that residents are safe. Currently the home is undertaking inappropriate decisions concerning medication and the pharmacist inspector is going to provided direction and advice when he inspects the processes at the home in the near future. St David`s APL DS0000055164.V296746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The performance in this group is good. Residents felt that their views were taken seriously, listened to and acted on. Policies and procedures are in place and staff are trained to ensure residents are protected from all type of abuse. EVIDENCE: The residents consulted during the inspection advised that if they had an issue it would be treated seriously by the management of the home and resolved quickly to their satisfaction. There are no outstanding issues currently. The home has appropriate policies and procedures in place to ensure that the residents are protected. Staff are trained in the use of the protection procedures and they were able to identify the different types of abuse when interviewed in private. St David`s APL DS0000055164.V296746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The performance in this group is adequate. St Davids provides an environment that is safe and comfortable. In general the home is clean and hygienic. There is an issue concerning the laundry and a requirement has been raised. EVIDENCE: A complete tour of the home was undertaken as part of the inspection process. A substantial redecoration programme has been undertaken and new carpets provided where necessary, this has provided a much-improved environment for the residents in the home, it was also understood that the outside of the home is going to be redecorated in the near future. During the tour it was noticed that the fire extinguishers are free standing. A requirement has been raised to ensure that they are appropriately secured to the wall. The laundry area of the home has a very dirty sink in it, this was discussed with the registered manager and a requirement has been raised for it to be cleaned or replaced. In the grounds of the home there are some workshops that residents have access to. This in an area with a large variety of stored items some of which may be hazardous, a recommendation has been raised in this report for a St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 17 protocol to be put in place to ensure that residents are accompanied be a member of staff when they are in this area to ensure their safety. St David`s APL DS0000055164.V296746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 The performance in this group is adequate. The staffing levels in the home remain at their previous satisfactory levels. There were some deficits in the staff personnel files. EVIDENCE: The home has a complete staff care team that have completed an appropriate induction and an active training programme is running to ensure a good quality service is provided. Staffing levels ensure that the needs of the residents can be met at anytime of the day or night. Three personnel files were examined during the inspection, all the checks on carers had been undertaken and were in place. However, some of the references were missing. It is essential that this is rectified without delay and a requirement has been raised to ensure this is achieved with the timescale agreed at the time of the inspection. St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 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 and 42 St Davids is well run and provides a good service for the residents. Residents feel that they are able to influence the service and feel consulted about everyday events. Health, safety and welfare issues are seen as important and are given priority. EVIDENCE: The registered manager of St Davids has a teaching degree and has six years experience in residential care. The home is well run and there is a quality assurance system in place to ensure the standards are maintained or improved. The residents interviewed during the inspection advised that the home had their confidence and they all felt consulted about matters that affected them, choice was always seen as most important for residents and was much appreciated. St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 20 The manager saw health and safety and welfare issues as very important and these were given priority. The home had appropriate electrical certificates in place for the installation and the appliances used. Appropriate fire precautions were undertaken. Secure storage was provided for cleaning chemicals and dangerous occurrences were reported appropriately. A recommendation has been raised in this report for a protocol to be produced to ensure that unused areas of the plumbing system are regularly flushed to ensure they are kept clear of unwanted bacteria. St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 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 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 2 STAFFING Standard No Score 31 X 32 X 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 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 2 X 3 X 3 X X 3 X St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 22 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 YA9 Regulation 13 Requirement The registered manager must ensure that all risks to service users are appropriately risk assessed. The registered manager must ensure that staff adhere to the correct policy and procedure for the administration medication. The registered manager must ensure that the sink in the laundry area is either cleaned or replaced. The registered manager must ensure that all the fire extinguishers in the home are suitably secured. The registered manager must ensure that all the documents called for in Schedule 2 are included in each of the personnel files. Timescale for action 27/08/06 2 YA20 13 29/06/06 3 YA30 23 11/07/06 4 YA24 23 11/07/06 5 YA34 33 27/08/06 St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 23 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 2 Refer to Standard YA24 YA24 Good Practice Recommendations The registered manager should provide a written protocol to ensure residents are accompanied by staff when in the workshop area of the home. The registered manager should provide a written protocol (to accompany the risk assessment) to ensure unused areas of the plumbing system are regularly flushed to ensure it is clear of unwanted bacteria. St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 St David`s APL DS0000055164.V296746.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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