Inspection on 14/11/06 for The Old Dairy

This inspection was carried out on 14th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

The Old Dairy 27/10/08

The Old Dairy 14/02/06

The Old Dairy 22/07/05

The Old Dairy 25/02/05

The Old Dairy 22/09/04

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 Old Dairy (The) 11 High Street West Lavington Devizes Wiltshire SN10 4HQ Lead Inspector Malcolm Kippax Key Unannounced Inspection 14th November 2006 12:55 Old Dairy (The) DS0000060333.V304014.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 Old Dairy (The) DS0000060333.V304014.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. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Dairy (The) Address 11 High Street West Lavington Devizes Wiltshire SN10 4HQ 01672 562755 01672 569477 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) Cornerstones (UK) Ltd Miss Lisa Driscoll Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Any placement for short-term care or for an emergency placement must be agreed with the Commission before the placement commences. For the purpose of this condition, short-term is defined as a placement that is expected to last not longer than 3 months. An emergency admission is defined as an admission whereby someone is likely to be placed at short notice without an up-to-date assessment of needs having been carried out and the person has not had the opportunity to visit the home prior to placement. 14th February 2006 Date of last inspection Brief Description of the Service: The Old Dairy is one of a number of care homes in Wiltshire that are run by Cornerstones (UK) Ltd. The Old Dairy is an old property in the village of West Lavington. Each service user has their own room and there are two communal rooms. There is a garden and parking area at the front of the property. A house vehicle is available for trips out. The Old Dairy is the service users permanent home for as long as this remains appropriate to their needs and wishes. Service users receive support from the home’s manager, a deputy manager and a team of support workers. Service users attend a range of activities in the community. The range of fees at the time of this inspection was from £632.65 - £1352.00 per week. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit to the home, which took place on 14 November 2006 between 12.55 pm and 4.40 pm. Some of this time was spent at a nearby hall, where service users were participating in day activities. A second visit was made to the home on 22 November 2006 between 10.20 am and 1.20 pm. The five service users were met with during the visits. The inspection focussed on the outcomes for three people in particular. Records were looked at in respect of these service users, as part of ‘case tracking’. The home’s manager was met with on 22 November and the deputy manager and staff members were met with during both visits. Evidence was obtained during the visits through: • • • • Discussion with service users, staff members, manager and deputy manager. Observation. A tour of the home. Examination of some of the home’s records, including three service users’ personal files. Other information has been received and taken into account as part of this inspection: • • • The home’s manager completed a pre-inspection questionnaire about the running of the home. Three local authority care managers and six of the service users’ relatives completed comment cards about the home. The five service users, with support from staff, completed surveys about what it is like to live at The Old Dairy. The judgements contained in this report have been made from the evidence gathered during the inspection, including the visits to the home. What the service does well: One person had moved into The Old Dairy on a permanent basis since the last inspection. Their needs were assessed and they had got to know The Old Dairy before moving in. This had provided good information about whether the home could meet the service user’s needs and was suitable for them. The service user was being well supported with settling into the home. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 6 The new service user’s personal file contained assessment records and guidance about their daily routines and their occupation during the week, which helped staff to provide consistent and individual support. The service users’ needs and personal goals are well reflected in their individual plans. The plans included guidance for staff about what service users like to do and how they can best be supported. They benefit from the home’s approach to risk taking, which assists them to be independent within their capabilities. The service users’ right to make decisions is respected, with some agreed restrictions in place for safety reasons. The service users attend a range of well established and newer activities during the week, when they can meet with other people and pursue particular interests. Service users said they enjoy their individual activities, such as photography, rambling, cooking and helping out on a farm. They are well supported with getting to their different activities. Service users receive very good support with their relationships and with keeping in contact with family members. The relatives who commented were very positive in their views about the home Service users can treat the home as their own, subject to some agreed restrictions. They help to choose the weekly menus. Service users can also have something different on the day if they wish and can chose to have some individual dishes that they particularly like. Service users benefit from the guidance that has been produced for staff, which helps ensure that personal care is provided in a way that service users prefer and meets their needs. They receive the support that they need with their health care. They are protected by the home’s arrangements for dealing with medicines. The service users have regular contact with the local community and the home is well placed for getting to the village’s facilities, including a convenience store. The accommodation is generally homely and is kept clean and tidy. Service users have personalised their rooms. Service users receive good continuity of support from the staff team. They benefit from staff members who they know well and are developing their individual skills. Service users benefit from an experienced home manager who is gaining relevant qualifications. Quality assurance is being well developed at an organisational level. There are systems in place for obtaining feedback about the service that service users receive. There are suitable arrangements in place for maintaining the health & safety of service users. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: The service users personal goals are recorded in their care plans, however it was not always clear how progress with achieving the goals is being monitored and assessed. It is important to record this, as it will help identify whether progress is being made as expected, or whether a service user needs further support to achieve the goal. Reviews of the service users’ care and support plans could be better recorded, to ensure that changes are clearly identified. The plans tend to be written from a staff perspective and could better reflect the views of service users and other people who have contributed to their content. The written format meant that they were not accessible to all service users. Work on improving the accommodation should continue; the kitchen is the main area in need of attention in the near future. The fitted units are showing signs of wear and tear and the condition of some drawers and work surfaces means that they can not easily be kept in a hygienic condition. The carpet in the dining room should also be replaced in the near future to improve the environment for service users. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 8 There is a comprehensive policy on staff training, although the training plan for the coming year does not include all areas of training that are required under the policy. 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. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 9 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 Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to the home. Prospective service users have their needs assessed and get to know The Old Dairy before moving in. This helps to ensure that the home can meet their needs and is suitable for them. EVIDENCE: It was reported at the last inspection that a service user from another Cornerstones (UK) home was visiting The Old Dairy at the time of the inspection. A file had been set up containing personal information and copies of letters, which had been sent to confirm the pre-admission arrangements, including an overnight stay. The home’s manager said that the visits were an opportunity to assess the suitability of the home for this person. The staff team had started to complete an assessment of needs record. Information was being collected for inclusion in a personal Service User’s guide. This person has moved into The Old Dairy on a permanent basis since the last inspection. The service user’s personal file contained assessment records and guidance about their daily routines and occupation during the week. This included working at a community farm, which the service user said they enjoyed. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made from evidence gathered before and during the visits to the home. The service users’ needs and personal goals are well reflected in their individual plans, which helps staff to provide consistent and individual support. Reviews of the plans could be better recorded, to ensure that any changes are clearly identified. Service users benefit from the home’s approach to risk taking, which assists them to be independent within their capabilities. The service users’ right to make decisions is respected, subject to some agreed restrictions being in place for safety reasons. EVIDENCE: Three service users’ personal files were looked at. Each contained a care and support plan that had been written or reviewed during the last six months. The plans consisted of a range of forms, covering areas, such as ‘Safety Awareness’, ‘Social Skills’, ‘Communication’, ‘Medication’ and ‘Daily Routines’. They provided clear guidance for staff about the service users’ needs and Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 12 preferences in these areas. The files themselves were well organised, although there was no separate review section on the forms and some changes in a plan had been made by crossing out the original wording and adding some new comments. It was not always clear when the changes had been made. The written format of the plans meant that they were not accessible to all service users or meeting their individual needs. Cornerstones (UK) has reported that the accessibility of information for service users is being looked at as part of a communications project, currently being undertaken. One part of the care plans included a section on ‘Issues’. Goals and personal objectives were also recorded, which showed how a particular issue was being followed up. The objectives covered a range of areas, with the aim of improving aspects of the service users’ lives. The objectives included, for example, service users receiving support with their emotional needs and with relationships. One service user had an objective that was to do with managing and storing their own belongings. As part of this, the service user was finding out about recycling and what could be done in the home. Various steps had been recorded to show how the objectives would be achieved although the forms did not include a section where progress could be recorded. The service users’ files included other guidelines and risk assessment records that provided more detailed information in areas such as safety when travelling in the home’s vehicle, when eating and when using some kitchen items. There were clear references within the service users’ individual plans to show where risk assessments had been undertaken. The manager said that house meetings had not been successful as some people found them difficult to manage and to participate in. Some matters and concerns relating to service users had been recorded by staff in a book. A change of rooms was being looked into at the time of the inspection. The book looked like a useful way of picking up on issues that service users might have raised in a meeting. Service users made decisions about what meals they would like. The choice of meals was recorded each day. Some restrictions on what service users could do were recorded in their care plans, together with the reason why these were necessary. This included, for example, a service user not accessing some facilities independently and not leaving the home unsupported. These restrictions were in place for reasons of personal safety. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is excellent. This judgement has been made from evidence gathered before and during the visits to the home. The service users have individual lifestyles and benefit from their participation in well established and some newer activities outside the home. Service users have regular contact with the local community and receive good support with their relationships. Service users can make choices and can treat the home as their own, subject to some agreed restrictions. There is a varied menu. Service users enjoy their meals and are able to choose dishes that they particularly like. EVIDENCE: There was a written timetable, which showed the service users’ daily activities and how they were occupied throughout the week. The timetable included a range of activities outside the home, some of which were provided directly by Cornerstones (UK). During the visit on 14 November, some service users Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 14 attended an arts and crafts session at a nearby hall. A skittles match and pub lunch was arranged on 22 November. At these times, service users mixed with people from other Cornerstones (UK) run homes. Service users were asked if they wished to attend; one person decided that they did not want to go out and play skittles and was able to do something else while staying at home. Changes in the service users’ day activities were discussed with Miss Driscoll. The Cornerstones (UK) activities were relatively new and had been useful in taking the place of day and resource centre sessions that had either ceased or become less available. A range of activities was available, including cookery, rambling, arts and crafts and swimming. Miss Driscoll said that it was intended that service users would continue to attend a range of community based activities, in order to provide them with experiences that were outside a solely learning disability setting. The weekly timetable showed that some service users were attending college courses and had individual work placements, in addition to the Cornerstones (UK) activities. During the visit on 22 November, one service user had been to a community farm and another service user attended a college course on photography later in the day. Transport was provided from the home. Another service user received one to one support with their day activities from a staff member. During the visit on 22 November, the activities had included going to a gym. Service users talked about their interests and pastimes. Service users had collected items, which were displayed in their rooms. One service user said that they enjoyed the skittle sessions and had a certificate in their room in recognition of their achievements. In their survey, one service user commented I like living here and going to daycare. I like walking and going to the gym’. Information was recorded in the service users’ support plans about their family relationships and how they maintained contact. In their comment cards, the service users’ relatives stated that they are welcome in the home at any time, can visit in private and are kept informed of important matters affecting their relative in the home. One person stated that support was provided with the travelling arrangements when their relative in the home came to visit and that this was much appreciated. Comments from another relative included ‘they regularly go out on visits and away on holiday’. One person commented that their relative in the home had a key worker who shows ‘a high level of commitment’. The home had received support from two behaviour nurses with carrying out a ‘Lifestyle’ risk assessment with one service user. The rights and responsibilities of service users were commented on in their individual care plans. The service users views on Church attendance were Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 15 recorded. There was section in the plans about voting and the support that service users would need with this. There were procedures and recording systems in place for staff to follow when supporting service users with managing their personal money. The service users spoken with said that they liked the meals. The service users’ care plans included an ‘Eating’ section, which provided information about individual needs and preferences. There was a weekly menu. This showed a ‘suggested dinner’, which was the meal that had been chosen at the beginning of the week when the menu was planned. Details of meals had also been recorded each day under an ‘actual dinner’ section, to show when a different meal had been chosen on the day. Alternatives were also recorded, as chosen by individual service users. This included for example, veggie burgers and one service user had recently had crab paste and feta cheese, which was reported to be a particular favourite. Sometimes people had gone out for a takeaway meal. During the visits, service users were asked what they would like for particular meals. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to the home. Service users benefit from the guidance that has been produced for staff, which helps ensure that support is provided in a way that service users prefer and meets their needs. Service users receive the support that they need with their health care. They are protected by the home’s arrangements for dealing with medicines, although a change in the storage arrangements would be beneficial. EVIDENCE: Support for service users with day to day needs was described in their individual plans, which also included guidance for staff about their usual routines at different times of day. There was evidence of the involvement of outside professionals and support from the local Community Team for People with Learning Disabilities (C.T.P.L.D.). One service user had an individual plan for the management of their epilepsy. A Community Nurse was reviewing this at the time of the inspection. Behaviour Nurses from the team had contributed to risk assessments that had been undertaken in respect of individual service users. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 17 The home had received positive comments about how a recent seizure had been responded to by staff. The service users’ files included information about the service users’ health backgrounds and records of their contact with GPs and other healthcare professionals. ‘Well Man’ check ups had been arranged. Some service users had recently had a flu jab. In their comment cards, each relative confirmed that they are satisfied with the overall care provided. Four relatives also added very positive comments, for example, ‘there is a vast improvement … this can only reflect on the care he is receiving from the staff’, ‘I consider we are very lucky’ and ‘I am very happy in the way (name of service user) is treated … he has been well looked after’. The three care managers also confirmed in their comment cards that they are satisfied with the overall care provided. Some health related objectives had been recorded as part of the support given to service users in order to achieve their personal goals. These included making a referral for the involvement of a behavioural nurse. One service user had an appointment in December 2006 to see a continence nurse. The service users’ daily records included a checklist for personal care that is completed by staff. Service users were receiving support with the administration and safekeeping of their medication. There was a written policy and procedure for this. Medication was received in pre-prepared cassettes, as part of a monitored dosage system. Two of the three service users being ‘case tracked’ had medication prescribed, which was being managed by staff. The records of administration had been initialled by staff and were up to date. Medication was kept within a large cupboard that was mainly used for the storage of files. The medication was kept securely, but it was agreed with Miss Driscoll that the cupboard would be reorganised and the medication kept in a new facility where it would be separate from other items. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to the home. Service users have the opportunity to raise concerns and are listened to by staff. Staff members receive training and guidance, which helps to protect service users from abuse. EVIDENCE: The Commission has not received any complaints about the home during the last twelve months. Service users varied in their capacity to make a complaint and the support that they would need with this. A pictorial complaints procedure had been produced for service users. There was a ‘Complaints’ section in the service users’ personal files. It was recorded that staff had talked through the complaints procedure individually with service users. A ‘Complaints’ book was kept in the home. There was information recorded regarding a neighbour’s concern about the fencing that had been erected between the two properties. This had been resolved. The book was also used to record concerns that had been raised by service users. As recommended at the last inspection, information was being recorded about how these concerns had been followed up. In their comment card, one relative stated that a complaint was managed very well with an excellent outcome. Another person commented ‘absolutely no Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 19 complaints’. Of the six relatives who commented, four confirmed that they are aware of the home’s complaints. The three local authority care managers stated in their comment cards that they have not dealt with any complaints about the home. The manager and staff team have had experience of making a referral under the Vulnerable Adults procedure. The Commission has been notified of these investigations. Staff members had received a copy of the ‘No Secrets in Swindon and Wilshire’ booklet and had received training through the local Vulnerable Adults Unit in 2005. The staff team had attended an ‘in-house’ training workshop in May 2006. The home’s policies and procedure file contained information on the signs of abuse and what to do if abuse is suspected. Miss Driscoll said that she would be obtaining a copy of September 2006 publication, ‘Policy and Procedures for Safeguarding Vulnerable Adults in Swindon and Wiltshire’. A staff member said that she had received training in physical intervention. Miss Driscoll said that refresher training was booked for January 2007. There was a policy on the use of physical intervention and pictorial guidance about how physical intervention should be undertaken, in accordance with the training given. Records, including body charts, had been completed in respect of incidents involving physical intervention. There was no statement on physical intervention and restraint which referred to the various documentation and records that staff needed to be aware of. Hazards associated with the service users’ behaviour and activities were recorded and had been assessed in order to reduce the risk of harm to service users and staff. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is adequate and improving. This judgement has been made using available evidence including the visits to the home. There was a homely environment, which is being improved with the provision of new facilities. The home was generally clean and tidy, although there were areas in need of attention. EVIDENCE: The Old Dairy is a detached property in a prominent position within the village. It is very close to some village amenities and is located between a public house with a restaurant and a convenience store. There is a garden and parking area at the front of the property. In their survey, one service user mentioned that the garden is too small and that they would like a larger home. Various improvements have been made to the accommodation over recent years. Refurbishment and the upgrading of facilities have taken place during the last twelve months. There was a new shower, and a bathroom had been converted to create two bedroom en-suite showers and toilets. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 21 There was a domestic type kitchen. A large upholstered chair had been placed at one end. The chair was visibly stained. Miss Driscoll said that it would be changed to a type that was more appropriate for this location. The fitted units in the kitchen were showing signs of wear and tear. The condition of some drawers and work surfaces meant that they could not easily be kept clean and in a hygienic condition. Staff members said that the carpet in the dining room had been down for several years. Its dark colour disguised much of the staining and use it had had over this time. A new carpet would not only be more hygienic, but could enhance the appearance of the room. Other areas of the accommodation looked clean and tidy. Miss Driscoll reported on further work that was planned to take place, including redecoration of the lounge and the fitting of a new door in one of the service user’s bedrooms. Miss Driscoll and staff members were aware of the need for the kitchen and the dining room carpet to receive attention, although a date for this work had not been confirmed. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 22 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, 33 and 35 Quality in this outcome area is mostly good; there was a shortcoming, in that the home’s training plan was not yet fully implemented. This judgement has been made using available evidence including the visits to the home. Service users receive good continuity of support from the staff team. They benefit from staff members who they know well and are developing their individual skills. (Standard 34 did not apply at the time of this inspection). EVIDENCE: No new staff members had been appointed since the last inspection. In addition to the manager and deputy manager, there was a permanent staff team of six support workers. Bank and agency staff were not used. There had been no changes in the staff team during the last 12 months. There was a written staff rota. Staffing levels increased at busy times of day and when service users needed support with attending activities outside the home. Sufficient staff were deployed at the time of the visits to meet the service users’ needs. One service user received one to one support with their activities during the day. In their comment cards, the service users’ relatives stated that, in their opinion, there were always sufficient numbers of staff on Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 23 duty. The relatives’ comments included ‘all staff are excellent’ and ‘wonderful staff who rarely change’. The care managers confirmed in their comment cards that staff demonstrate a clear understanding of their clients’ needs. Relationships between staff and service users during the inspection appeared to be friendly and positive. Four support workers had achieved National Vocational Qualification (NVQ) at level 3. Some staff members had been ‘re-inducted’ during the last year, using Learning Disability Award Framework (LDAF) accredited training, which was not available to them when they were first employed. Cornerstones (UK) had a training manager who was based in one of the other homes and co-ordinated staff attendance on courses and events. The home received training schedules, which included details of training events arranged for the coming months. There was a training policy, which set out the training that staff would receive. Areas of training were listed under the headings of ‘Essential’, ‘Desirable’, ‘Specialist’ and ‘Mandatory’. The training plan looked very comprehensive. Priorities were identified for the training events that staff members needed to attend during their first year. Miss Driscoll said that she had recently met with the training manager and produced a staff training and development plan for the year ahead. The plan did not reflect all areas of training, as set out in the training policy. Particular areas of training had not been included in the plan. For example, there was no provision for disability and equality training, although this was listed on the plan as essential. Staff members had individual training records, which were kept in the home. The focus was on mandatory training. All staff had received training in first aid, with some people due to attend a refresher course by the end of the year. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 24 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 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to the home. Service users benefit from an experienced home manager who is gaining relevant qualifications. Quality assurance is being well developed at an organisational level. There are systems in place for obtaining feedback about the service that service users receive. There are suitable arrangements in place for maintaining the health & safety of service users. EVIDENCE: Miss Driscoll has been the home’s manager for over a number of years and has overseen a number of developments during that time. Miss Driscoll said that she was near to completing the units for the Registered Managers award and would shortly be starting her NVQ in care at level 4. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 25 In their comment card, one relative stated that ‘the home is just that, a home’. The comments made by the care managers and other relatives were indicative of a well run home. Quality assurance has been developed during the last year. A Cornerstones (UK) plan for quality assurance was produced in September 2006. This is a comprehensive document, setting out the organisation’s intentions and how these will be put into practice. Miss Driscoll said that the development plan for 2007 would be based on an internal audit of the standards, the care review system, and on questionnaires that were sent out to outside professionals and to the service users’ relatives in July 2006. An analysis of the feedback received from the questionnaires was sent to the Commission prior to the inspection. The quality assurance plan included a section on communication with service users and how the organisation will seek to establish effective methods to achieve this. It was confirmed with Miss Driscoll that the service users’ views should be paramount within the organisation’s system of quality assurance, with their views reflected in the report that is produced under Regulation 24 of the Care Homes Regulations 2001. This regulation has recently been amended and includes details of the type of report that needs to be produced in connection with quality assurance. The manager reported that the home’s Statement of Purpose was currently being reviewed. There was discussion with Miss Driscoll about the need to review the Service User’s guide and to include details of fees and charges. This follows a recent change in the regulation concerning the contents of service users’ guides. The home’s fire log book was looked at. There was an up to date record of fire precaution checks and activities. Information was received from the manager about arrangements for the servicing and maintenance of equipment in the home by outside contractors. P.A.T. testing had been carried out in March 2006. The home’s boiler was serviced on 03/10/06. Temperature regulators were fitted at hot water outlets and radiators had covers fitted to reduce the risk of burning. An ‘in-house’ health and safety checklist had last been completed in July 2006. It was agreed with Miss Driscoll that it would be useful to complete this more frequently. One staff member said that they were booked to go on a health and safety course in December 2006. Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 26 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 3 33 3 34 x 35 2 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 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Old Dairy (The) DS0000060333.V304014.R01.S.doc Version 5.2 Page 27 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. 1. 2. 3. 4. Refer to Standard YA6 YA6 YA6 YA23 Good Practice Recommendations That changes to the service users’ care plans are clearly identified and dated, without handwritten alterations. That the service users’ progress with meeting their personal goals is consistently recorded. That the care plans are produced in formats that meet the needs of individual service users. That a statement on physical intervention and restraint is produced, which refers to the various documentation and records that staff need to be aware of. That plans are drawn up for the refurbishment of the kitchen and dining room. That the home’s staff training and development plan for the coming year reflects all areas of training as identified in the training policy. DS0000060333.V304014.R01.S.doc Version 5.2 Page 28 5. 6. YA24 YA35 Old Dairy (The) Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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