Care Home: Dean View Villas

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What the care home does well Dean View VillasDS0000000255.V374852.R01.S.docVersion 5.2The service users plans are excellent, giving clear guidance, they are in an easy to read format and are regularly reviewed and updated. The home and organisation has good systems to enable people who use the service to share their views and they continue to look at ways of involving people who use the service and improving individualised services. People who use the service said, and it was seen, that staff were kind, considerate and supportive. The manager has addressed all of the previous requirements and recommendations. What has improved since the last inspection? The service user guide has been updated to enable people who use the service to have more information about the home. The care plans are reviewed on a more regular basis to enable staff to have updated information on individual needs. The care plans have been developed to make them more user friendly and to increase the involvement of people who use the service and their families. The risk assessments have been reviewed and updated for all individuals who use the service. This will help protect people who use the service. Dependency assessments have been undertaken for all individuals and additional support staff have been provided. This will help give individuals more support and meet individual needs and lifestyles. A redecoration and refurbishment plan for the home has been implemented which has provided more comfortable and pleasant surroundings for people, who use the service. The overhead tracking and hoist have been replaced improving the transfer and protecting the people who use the service. The staff training programme has been developed and this has enabled the manager to have an overview of staff skills and knowledge and help them to provide individual care for people who use the service. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 The internal quality assurance audits are undertaken more consistently and this has helped protect people who use the service, relatives and staff. The fire safety testing and fire drills are undertaken at the recommended timescales and this has helped protect people who use the service, their relatives and staff. What the care home could do better: Complete the refurbishment of villa 1 to enable all service users to live in a comfortable and pleasant environment. Continue the development of service users involvement and communication methods. Key inspection report CARE HOME ADULTS 18-65 Dean View Villas 579 - 581 John Williamson Street South Shields Tyne And Wear NE33 5HW Lead Inspector Mary Blake Key Unannounced Inspection 17th July 2009 10:00 Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dean View Villas Address 579 - 581 John Williamson Street South Shields Tyne And Wear NE33 5HW 0191 455 9903 0191 454 8416 deanview@c-i-c.co.uk www.c-i-c.co.uk. Community Integrated Care 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) Kerry Ann Welch Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Learning disability - Code LD, maximum number of places: 8 The maximum number of service users who can be accommodated is: 8 11th July 2008 Date of last inspection Brief Description of the Service: Dean View Villas is a care home providing personal care and accommodation for up to 8 people with learning and physical disabilities. Dean View Villas was purpose built as a care home. It comprises two inter linked villas, both of which are suitably equipped to meet the needs of people who currently live there. All bedrooms are for single occupancy and are suitable for people who use wheelchairs. The home was specifically designed for people with physical disabilities and there is good access into and around all areas of the home. The fees are made up of Social Services Department contributions by the respective placing authority, and a contribution, from their benefits, by people who use the service. A statement of purpose, service user guide and last inspection report were available from the office. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star good service. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the visit: We looked at: • Information we have received since the last visit on 11th July 2008. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals, including surveys. During the visit we: • Talked with people who use the service, relatives, staff, the manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe & comfortable. We told the senior support worker what we found. What the service does well: Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 6 The service users plans are excellent, giving clear guidance, they are in an easy to read format and are regularly reviewed and updated. The home and organisation has good systems to enable people who use the service to share their views and they continue to look at ways of involving people who use the service and improving individualised services. People who use the service said, and it was seen, that staff were kind, considerate and supportive. The manager has addressed all of the previous requirements and recommendations. What has improved since the last inspection? The service user guide has been updated to enable people who use the service to have more information about the home. The care plans are reviewed on a more regular basis to enable staff to have updated information on individual needs. The care plans have been developed to make them more user friendly and to increase the involvement of people who use the service and their families. The risk assessments have been reviewed and updated for all individuals who use the service. This will help protect people who use the service. Dependency assessments have been undertaken for all individuals and additional support staff have been provided. This will help give individuals more support and meet individual needs and lifestyles. A redecoration and refurbishment plan for the home has been implemented which has provided more comfortable and pleasant surroundings for people, who use the service. The overhead tracking and hoist have been replaced improving the transfer and protecting the people who use the service. The staff training programme has been developed and this has enabled the manager to have an overview of staff skills and knowledge and help them to provide individual care for people who use the service. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 7 The internal quality assurance audits are undertaken more consistently and this has helped protect people who use the service, relatives and staff. The fire safety testing and fire drills are undertaken at the recommended timescales and this has helped protect people who use the service, their relatives and staff. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 8 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 Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have updated information about the home. EVIDENCE: The service can accommodate up to eight people with learning and physical disabilities and is full, there had been no new admissions over a number of years but the plans they have in place to introduce prospective service users are good. There is a Statement of Purpose and a Service Users’ Guide to provide service users and potential service users with information about the home. This has been reviewed and updated to provide information in a user friendly format. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are consulted about and enabled to participate in decisions about their lives. Their needs are met and this is evident in their care plans. EVIDENCE: The care plan format has been reviewed and updated and now provides an excellent document to support the needs of the people who use the service. The care plans case tracked were person centred and focussed on the individual’s strengths and personal preferences. There are methods to help individuals to contribute to the development of their plan. Staff have the skills to support, engage and encourage the individual to be fully involved. Key workers actively provide one to one support, keep the care plan up to date and Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 11 make sure all staff always know the persons current needs and wishes. The plans included photos and pictures and were written in plain language. It is an up to date working tool used by the individual and all staff involved. The care plan can easily be used by people who are not familiar with the individual to deliver a personalised quality service. The care plans include a comprehensive risk assessment, which is regularly reviewed and updated. The service has a positive attitude and risks are managed positively to help people who use the service lead the life they want. The quality of the information was consistent and detailed. There is good liaison with supporting professionals. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 12 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): This is what people staying in this care home experience: 12,13,15,16 & 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are enabled to participate in appropriate activities of their choice and to maintain relationships with friends and family. EVIDENCE: People who use the service are offered the opportunity to join in a range of social and leisure activities. They have the opportunity to use community facilities for leisure activities e.g. going to the cinema, to the pub, eating out, shopping etc. They are offered the opportunity to experience new activities and leisure pursuits as well as supported where necessary to continue with hobbies and interests. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 13 Staff assist and encourage people who use the service to maintain family links and previous friendships, respecting individual wishes. Individuals are supported to attend day care and college. They have been on holidays at home and abroad. Staff support people who use the service to maintain existing friend and social relationships. Staff seek permission prior to entering individual rooms and were communicating well with people who use the service. People who use the service were observed to move freely around the villas. People who use the service have been involved in the review of menus. They were observed having a leisurely brunch and coffee in a relaxed and social setting with good staff support evident. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and healthcare support is provided in the way that people who use the service prefer. EVIDENCE: Information from people who use the service, staff, supporting professionals and relatives showed that those who require personal support are given this in a way that protects their dignity and maximises their independence. They are given personal choice and support in areas such as getting up, personal care and how they spend their time. Individual health needs are identified and people who use the service are supported to access community health services such as doctor, district nurse, dentist, and optician. They receive physiotherapy, psychiatry and psychology health support. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 15 The ordering, storage, administration and disposal of medication were satisfactory and had been reviewed by the community pharmacist. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The views of people who use the service and their relatives are taken seriously. This helps to protect them. EVIDENCE: There have been no recorded complaints since the previous inspection. A complaint procedure is in place. Staff were aware of taking the views of people who use the service seriously and of listening to, observing and responding to any signs of issues. People who use the service are given the complaints procedure in a number of formats and it is easy to follow. Some staff have undertaken the one day training on the Protection of Vulnerable Adults. Staff said they were aware of the whistle blowing policy and felt able to raise concerns if necessary. A safeguarding issue had been appropriately managed. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 29 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The facilities meet the needs of the people who use the service are homely and clean. EVIDENCE: Dean View Villas was purpose built as a care home to provide personal care and accommodation for up to eight people with learning and physical disabilities. The home’s two inter-linked villas were designed to accommodate people who use wheelchairs. Each villa has a lounge, kitchen, dining room and a conservatory. Furniture in hallways and corridors provides additional communal areas. The layout of the home is spacious enough for wheelchair access. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 18 Dean View Villas is comfortable and attractively furnished. Individual bedrooms are well presented and reflect their individual styles and tastes. The home has sufficient and suitably equipped bath / shower rooms. Villa two has now been redecorated and refurbished with similar plans for Villa one to commence in September 2009. Overhead tracking and hoists had been replaced and were now in use. The home was generally clean and tidy. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34, 35 & 36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are adequate numbers of appropriately recruited, skilled and experienced staff to care for the people who use the service. EVIDENCE: Staffing rotas showed that the following staff are in place: Two support workers for each villa during the day and one waking and one sleeping staff member during the night Individual dependency reviews are undertaken. Staff numbers have been increased, and there are now sufficient staff to provide support for individuals to engage in activities outside of the home. Recruitment procedures within the home are safe. Records confirm that appropriate checks are carried out for all staff. Applicants for employment Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 20 complete an application form and two references are obtained. A reference from the last employer is requested, plus one other. Any gaps in employment are explored at interview. Each member of staff receives a contract of employment and job description. Discussions with the senior support worker and staff and examination of individual staff training files confirmed that staff had undertaken mandatory training. Staff spoke knowledgably about the individual needs of people who use the service. Staff and resident meetings are now being held. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The views of people who use the service and their families are supported and underpin the development of the home and their health, safety and welfare are protected. EVIDENCE: The manager has completed the fit person process to be registered with CQC. Observations of staff and people who use the service showed that they felt confident with the openness and approachability of the manager. The manager is qualified and experienced and communicates a clear sense of direction and Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 22 leadership and has implemented positive changes to the practices within the home. In house quality audits were comprehensive and were now carried out consistently. Sufficient fire system testing and fire drills were now being carried out. Accidents were appropriately recorded and there was management overview of these. Providers’ visits have been undertaken at the required monthly frequency. Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 23 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 3 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 3 26 x 27 x 28 x 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 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 Version 5.2 Page 24 Dean View Villas DS0000000255.V374852.R01.S.doc 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. 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 Refer to Standard YA34 Good Practice Recommendations Consideration should be given to staff having ID cards, to use when supporting residents away from the home, in case of accident or challenge by another agency. (progress being made) To complete the refurbishment of Villa one 2 YA24 Dean View Villas DS0000000255.V374852.R01.S.doc Version 5.2 Page 25 Care Quality Commission North East Region Citygate Gallowgate Newcastle Upon Tyne NE1 41PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.Northeastern@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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