Care Home: Dee House

Similar services:

• Sunny Bank (P.R.S.) Ltd
• Ashwood Court Unit 1
• Thornton Lodge
• Alfred House Residential Care Home
• Barkerhouse Road (123)
• Fernhaven
• Thames House
• Creative Support

What the care home does well People who live at the home like the way it is laid out and say it is comfortable and homely. It is decorated in a domestic style; all the rooms are bright and well equipped so people live in surroundings that suit their needs. All of the people who live at the home praised the staff team and the standard of care and services provided. Care staff work in partnership with the each person and their representatives, including relatives and health and social care professionals, so the needs of the people who live at the home are met and care and support is provided in a way they prefer. The principles of privacy and dignity are promoted at the home so the people who live there feel respected and valued. The home is managed by an experienced and qualified manager so care staff receive the support, leadership and guidance they need to operate as an effective team. The care staff are experienced, well trained and skilled so the people who live at the home know they are in safe hands and have confidence in the staff team`s abilities. Health care professionals work closely with the staff team to ensure that the health care needs of the people who live at the home are met. Five health care professionals responded to the survey. They were unanimous in their praise for the standard of care provided which was described as excellent. What has improved since the last inspection? The home has been redecorated and other improvements have been made with new flooring in some areas and level access provided to the shower to make sure that the facilities at the home are suitable for the people who live there. All staff working at the home have had training in adult safeguarding procedures so they know when incidents must be referred to the local authority to ensure that vulnerable people are safeguarded from abuse and potential for abuse. What the care home could do better: Appropriate records need to be kept of all medicines received and administered in the home to ensure that the people who live there receive their medicines as prescribed. Information including the statement of purpose, service user`s guide and complaints procedure should be made available in other formats including large print, with illustrations, or on audiotape as required so it is easier for people to understand. Managers and staff should find out about "person centred care planning" with a view to developing the home`s assessment and care planning systems to make the best use of resources and ensure the personal development needs of all people who live at the home are met in the best possible way. Consideration should be given to producing a risk screening document to help staff identify all potential hazards to people who live at the home so arrangements to ensure each persons` safety are identified, recorded and confirmed in writing then reviewed and evaluated. All of the home`s quality assurance processes, including a survey of the views of the people who live there, their relatives and their health and social care professionals, should be carried out so the home continues to develop practices based on the views of the people who use the service and their representatives. CARE HOME ADULTS 18-65 Dee House 20 Sealand Road Chester Cheshire CH1 4LB Lead Inspector David Jones Unannounced Inspection 12 and 18 October 2007 2:15 Dee House DS0000006547.V351400.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 Dee House DS0000006547.V351400.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. Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dee House Address 20 Sealand Road Chester Cheshire CH1 4LB 01244 375820 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) joy.swainson@muir.org.uk Muir Group Housing Association Limited Ms Joy Swainson Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 9 service users in the category MD (Mental disorder, excluding learning disability or dementia) 4th August 2006 Date of last inspection Brief Description of the Service: Dee House is a care home for nine people who have mental health needs. It is owned and operated by Muir Group Housing Association Limited. It is located on Sealand Road, within a mile of Chester City Centre. The premises comprise two terraced properties linked by a conservatory extension to the rear. Accommodation for residents comprises nine single bedrooms (on two floors), two lounge areas, a dining room, kitchen and separate laundry. Standards of décor, furnishings and fittings are good throughout the home, as are standards of hygiene and cleanliness. Residents are encouraged to participate in the running of the home, and they are supported by staff to make full use of community facilities/amenities for shopping, recreation, education and healthcare. Information about Dee House including the statement of purpose, service users guide and complaints procedure is made available to each of the people who live at the home and can be obtained by contacting the home on the telephone number given above. Information provided by the registered manager on 02/11/07 confirms that fees for residential accommodation and care are £353.91, per week. There are no additional charges other than hairdresser, toiletries, and other sundry items charged at cost. Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection of Dee House was unannounced. It included a visit to the home that took place over two days taking 6 hours and 35 minutes in total. The visit was just one part of the inspection. Before the visit, the manager was asked to complete a questionnaire to provide detailed information about the home and how it is meeting the needs of the people who live there. CSCI questionnaires were also made available for the people who live at the home, their families and health and social care professionals and their views have been taken into account. Other information received since the last key inspection was also reviewed. During the visit, various records were looked at and a tour of the home was carried out. Observations were made of how staff interacted with and provided support and care for the people who live at the home. A number of people who live at the home were spoken with. They gave their views and these have been included in this report. What the service does well: People who live at the home like the way it is laid out and say it is comfortable and homely. It is decorated in a domestic style; all the rooms are bright and well equipped so people live in surroundings that suit their needs. All of the people who live at the home praised the staff team and the standard of care and services provided. Care staff work in partnership with the each person and their representatives, including relatives and health and social care professionals, so the needs of the people who live at the home are met and care and support is provided in a way they prefer. The principles of privacy and dignity are promoted at the home so the people who live there feel respected and valued. The home is managed by an experienced and qualified manager so care staff receive the support, leadership and guidance they need to operate as an effective team. The care staff are experienced, well trained and skilled so the people who live at the home know they are in safe hands and have confidence in the staff team’s abilities. Health care professionals work closely with the staff team to ensure that the health care needs of the people who live at the home are met. Five health care professionals responded to the survey. They were unanimous in their praise for the standard of care provided which was described as excellent. Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Dee House DS0000006547.V351400.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 Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are interested in moving to Dee House have their needs assessed and are provided with the information about the care, facilities and services provided so they know how their needs can be met at the home before they make a decision about moving in. EVIDENCE: People who are interested in moving to Dee House are provided with a statement of purpose and service users guide so they have the information they need to make an informed choice about moving to the home. These documents provide detailed information about the home including the philosophy of care and facilities and services provided but they are lengthy so some people may find them difficult to read. The manager said that consideration is being given to how to make the information more accessible and meaningful to all the people who live at the home. The use of large print, audiovisual media, illustrations and photographs should be explored to find the best way of presenting the information so all people who live at the home are helped to understand it. Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 9 Assessment and admissions procedures are well established so people wishing to move to the home have their needs assessed before they make any decisions about moving in. The care records of two people living at the home were read during the visit. These contained assessments based on the person’s abilities and needs in coping with everyday living, and plans of care for any needs identified at the assessment so the person moving in knows how their needs are to be met. Dee House DS0000006547.V351400.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person living at the home is involved with the development of their individual care and support plans so they receive the care and support they need in the way they prefer. EVIDENCE: People who live at Dee House are involved in planning their care and support so they are helped to maintain control of their lives and develop a lifestyle that reflects their needs and personal goals. Care and support plans reflect the individual’s needs and personal preferences and are developed and agreed with them so they receive care and support in the way they prefer. The care planning system used at the home is based on multidisciplinary assessment of each person’s needs and continuous development through monitoring, evaluation, review and working in partnership with the individual and their health and social care professionals. Care plans address each individual’s personal, health and social care needs but do not always identify Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 11 their personal life goals and aspirations. Discussion with staff and the people who live at the home confirm that these needs were being addressed but what staff were doing to help and assist each person was not always recorded. Managers and staff should explore the concept of “person centred care planning” with a view to developing the home’s assessment and care planning systems to make the best use of resources and ensure the personal development needs of all people who live at the home are met in the best possible way. Risk assessment is at the centre of the home’s assessment and care planning processes. Staff understand the importance of people being supported to take control of their own lives, and encourage them to exercise their rights to make their own decisions and choices. There are many examples where people are being helped to manage risk in the interests of a fulfilling lifestyle including going out into the local community and engaging in activities and social events. Limitations on freedom of movement or power to make decisions are only made in agreement with the person and in their best interests when there is a risk to health or personal injury to the individual or others. However, some identified risks were being managed but were not recorded. For example: one of the people who lives at the home is deemed to be at risk if they were to go out into the community without the support of staff. This presents the individual with limitations on their freedom of movement because they need a member of staff to go with them when they go out. The person said that they agreed with this and were quite happy with the arrangements. However, it is important that the risk assessment and reason for any limitation on an individual’s freedom of movement is confirmed in writing so it can be reviewed to make sure it is required in the best interests of the person and their rights preserved. Consideration should be given to producing a risk screening document to help staff identify all potential hazards that may be presented to people who live at the home so all control measures can be evaluated to ensure each person’s safety and well being. All people living at the home spoke highly the standard of support, care, facilities and service provided. They are encouraged to take the initiative to meet visitors at the front door and welcome them in. They are involved with the running of the home and are consulted on the quality of meals, standard of care and facilities and services provided. Residents meetings are held where they are encouraged to discuss any matters that are important to them. Minutes of the meetings are made available to all who live at the home. Dee House DS0000006547.V351400.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): 11, 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home are encouraged to take part in a range activities so that they can use local facilities, participate in new experiences and lead fulfilling lives in the community. EVIDENCE: The people who live at Dee House are able to make choices about their life style and say they are happy with the range of activities on offer. They take part in everyday social activities within the community and some also attend a day centre for part of the week. Holidays and day trips are organised regularly regular basis so people always have something to look forward to. There is a timetable of weekly activities on the notice board. The people who live at the home are involved in all ordinary domestic routines. They are encouraged to develop daily living skills and take responsibility for their own rooms. They are each allocated a specific morning or afternoon to do their Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 13 laundry and in addition have various jobs to do including setting the tables and vacuuming. The atmosphere in the home is relaxed and sociable. Staff have good relationships with the people who live there; they interact with mutual respect and courtesy and enjoy a laugh and a joke. Staff tend to remain in the background so as to encourage the people who live in the home to take the initiative to do things for themselves but staff are available and were seen to offer timely prompts to enable people to cope independently with everyday living tasks. This shows respect for the people who live at Dee House and reinforces their rights and the fact that it is their home first and foremost. Care plans address each individual’s personal, health and social care needs but do not identify their personal life goals, hopes desires and aspirations. Discussion with managers, staff and the people who live at the home confirms that the staff team are instrumental in helping people to explore and take advantage of opportunities for social inclusion, occupation and personal growth and development but the arrangements made to achieve these goals are not always recorded. For example: one of the people who lived at the home expressed aspirations for independent living and work. The staff team had tried to help the person to achieve their goals but a number of obstacles had prevented further development. “Person centred planning” will assist staff to help the people who live at the home to identify their aspirations and find ways and means to get around obstacles so they achieve their life goals as far as possible. Staff support the people to maintain family links, friendships and personal relationships. The people who live at the home are able to entertain their guests in private if they wish. Visiting relatives speak highly of the staff team and standard of care facilities and services available. All people spoken with during the inspection visit were happy about the standard of food at the home. Individual likes and dislikes are known and catered for. Menus are illustrated to help people read and understand them. They show that a varied and nutritious diet is on offer. Choice is offered with every meal with a range of alternative meals available including a healthy option. Dee House DS0000006547.V351400.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs and the principles of respect, dignity and privacy are put into practice and promoted. However arrangements for the safekeeping, recording and administration of medicines need review and revision so the people who live at the home are assured they will always receive their medication in accordance with their needs. EVIDENCE: Personal health care needs including specialist health care needs and dietary requirements are clearly recorded in each person’s care plan, which provides an overview of their health needs and acts as an indicator of change in health requirements. Managers and staff have developed excellent working relationships with the various health care professionals who see the people who live at the home regularly. CSCI comment forms were received from five health care professionals including three community mental health nurses, a consultant psychiatrist and a general practitioner. All praised the home and the standard Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 15 of care provided. Staff are said to be skilled, experienced and work in partnership with health care professionals and the individual to ensure the their health care needs are met. Some of the comments made by health care professionals included: • “Caring motivated staff, who each have residents’ best interests at heart. Treat each person individually and in holistic manner. Staff respond quickly to change, encourage them and show considerate attitude to them”. “Personalised care excellent communication”. “Excellent service, residents treated with utmost respect, encouraged to improve social inclusion. Skills and understanding of needs make for very well managed environment”. “Provides a friendly atmosphere. It is their home and staff treat it as such. All treated as individuals, they have their social needs met, holidays, outings and are encouraged to keep regular contact with family and friends”. “All staff are extremely respectful and are fully aware of all residents need for dignity and privacy, and they ensure any visitors to the house are also made aware of this”. “The staff at Dee House are extremely caring toward residents and I would not hesitate to recommend them”. • • • • • The people who live at the home and their relatives were unanimous in their praise for the home, the staff and the standard of care and support provided. All said the staff have the right skills and experience to meet the different needs presented by the people who live at Dee House including those associated with their race, ethnicity, age, disability, gender faith or sexual orientation. Records of the stocks of medicines received were not up-to-date so managers and staff would have difficulty in carrying out a medicines audit. Errors in recording were made on 8th, 13th and 14th October 2007 so the records did not show that people were receiving their medication in accordance with their needs. There was no record of a medicines audit being completed in the recent past. Staff have received training in medicines management and administration. However the home’s medication policy, procedures and practices need review and revision so staff have the guidance they need to ensure that medicines are administered, stored and recorded appropriately. Dee House DS0000006547.V351400.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Dee House are able to express their concerns and have access to an effective complaints procedure. Staff have guidance and training to make sure the people who live at the home are safeguarded from abuse, and have their rights protected. EVIDENCE: Managers and staff have a positive attitude toward receiving complaints and people who live at the home say staff listen and act on what they say. No complaints have been received since the last inspection. People who use the service have a complaints procedure that sets out how to make a complaint and the action that will be taken by the home in response. All of the people spoken with and those responding to the survey were aware of how to make a complaint. The manager said that some of the people who live at the home have difficulty reading and understanding documents written in a standard format so staff will go through any such document with them on request. The complaints procedure needs to be produced in a variety of formats which could include large print, illustrations, audio and photographs so all individuals have access to the information they need to make a complaint. The complaints procedure is available in the home and is made available to other interested parties or professionals on request. Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 17 Robust procedures for responding to suspicion or evidence of abuse or neglect are in place including whistle blowing as in accordance with the Public Interest Disclosure Act 1998 so staff have the guidance they need in the event of suspicion or evidence of abuse. All staff working at the home have had training on adult safeguarding procedures within the last 12 months so they know when incidents must be referred to the local authority to ensure that vulnerable people are safeguarded from abuse and potential for abuse. Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained so people who live there live in comfortable, clean surroundings that meet their needs. EVIDENCE: Dee House is in a residential area of Chester with convenient access to shops, public transport and other local amenities. The premises comprise two terraced properties linked by a conservatory extension to the rear. People who live at Dee House like the way it is laid out and say it is comfortable and homely. It is decorated in a homely manner and all of the rooms were bright and well equipped with domestic furniture. There is a rolling programme of redecoration and refurbishment and the manager confirmed that Muir Housing respond promptly to requests for repairs. There is pleasant well-maintained courtyard/back-garden for all to enjoy. The home has responded to the national ban on smoking in all public places that came into effect on 1st July 2007. Management are taking advantage of an Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 19 exemption that applies to personal care homes and have designated a ground floor room as the smoking room. People who live at the home said they are quite happy with this arrangement and some enjoy a cigarette in the back garden. The home is clean and well maintained throughout. All people responding to the survey said the home is always clean and fresh. Systems are in place regarding food hygiene and infection control so people are protected from possible infection and food contamination. Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are skilled, well supported and have access to effective training so they have the right skills to meet the needs of the people who live in the home. EVIDENCE: Staff were seen to carry out their work with care, good humour and respect for the people who live at Dee House. The staff group appear to be an effective tea; they work together with the benefit of shared aims and objectives and are clear about their individual roles and responsibilities. People who live at the home and visiting relatives speak highly of the staff team saying they are competent, skilled and work in partnership to ensure the needs of the people are met. Communication is said to be excellent and one relative stated: “the staff at Dee House have the skills and experience to look after any person properly, they’re Great.” One of the people living at the home said they “like the staff”, “they are very happy, and get on with the staff too”; another said, “The staff here are really excellent, they are wonderful and worth their weight in gold”. All the people responding to the survey said they Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 21 are always treated well with the exception of one who said they are usually treated well. Information provided by the manager and discussion with staff confirmed that the home operates an effective staff-training programme. Of the eight care staff, five have achieved an NVQ at level 2 or above. There has been no movement in the staff team for three years; however the most recently recruited staff member confirmed that they had received induction training that met the standards set down by the national training organisation now known as Skills For Care. All staff spoken with said training opportunities were excellent; all had benefited from training in equality and diversity and adult safeguarding procedures within the last 12 months and the deputy manager had completed NVQ level 3. All staff spoken with were knowledgeable about equality and diversity so they knew the arrangements for ensuring equality, valuing diversity and developing services to meet all people’s needs irrespective of their race, ethnic origin, disability, gender or sexual orientation. Feedback from people who live at the home, their relatives and health care professionals indicates that staff are employed in appropriate numbers to ensure the well being of the people who live at the home. All staff spoke highly of the manager saying communication in the home is good, they have regular supervision and regular staff meetings so the people who live at the home benefit from a well informed and appropriately supported staff team. Arrangements for the recruitment of staff are thorough so vulnerable people are protected from possible abuse, harm or poor practice. Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at Dee House benefit from the way the home is run, which is based on openness and respect, and in their best interests. However quality assurance processes need to be implemented to make sure future developments in the home continue to be based on the views of the people who live there. EVIDENCE: The manager is registered with the Commission for Social Care Inspection and is a qualified nurse (RMN). She achieved the Registered Managers Award in 2005. She has developed her knowledge through further training courses including equality and diversity, first aid and fire safety lectures. The home is well managed with positive outcomes for the people who live there. People Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 23 who live at Dee House are involved in running the home and planning their own care so they receive care and support in the way they prefer. Managers, staff and the people who live at Dee House have good relationships based on mutual regard and respect. There is an open culture where individuals feel safe and have confidence to speak out about the pros and cons of living in a residential care setting. Residents’ meetings are held approximately every 3 months. People living at the home said this is sufficient. A representative of the organisation that owns the home had not carried out monthly management visits to the home since January 2007. These visits are an important aspect of the home’s management arrangements and it is a requirement of the Care Homes Regulations that these visits are made at least once a month to check how the home is running. Managers and staff are committed to continuous improvement and established quality assurance processes are in place for consulting people who live at the home about quality issues. However these quality assurance processes have not been consistently put into practice. There has been no survey of the views of the people who live at the home or their representatives including relatives and health social care professionals. An annual report on how the home is addressing quality issues has not been produced and other aspects of the home’s quality assurance system have not been put into practice including monthly and quarterly monitoring reports. The management team will need to ensure that the home’s quality assurance systems are put into practice to ensure continuous development based on seeking the views of the people who use the service and their representatives. Muir Group Housing Association Ltd seeks to ensure the health and safety of all employees and people who live at Dee House. Risk assessment and risk management is central to the conduct of the home. The manager and deputy manager ensure that risk assessments are carried out for all working practices and significant findings are recorded and reviewed. Regular maintenance and safety checks are carried out at the home to ensure the safety of the staff and people who live at the home. These include fire safety equipment; smoke alarms, emergency lighting, water temperature checks regarding legionella, electrical wiring and emergency call systems. Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 24 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 25 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. 1 Standard YA20 Regulation 17(1) Timescale for action Appropriate records must be 15/11/07 made of all medicines received and administered in the home so the people who live at the home are protected and are assured they will receive their medication in accordance with their needs. Requirement 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 YA1 Good Practice Recommendations Information, including the statement of purpose, service users guide and complaints procedure, should be made available in user-friendly formats including large print, with illustrations or on an audiotape where required so all the people who live at the home can understand this information more easily. Managers and staff should explore the concept of “person centred care planning” with a view to developing the assessment and care planning systems used at the home to make the best use of resources and ensure the personal development needs of all people who live at the home are DS0000006547.V351400.R01.S.doc Version 5.2 Page 26 2 YA6 Dee House 3 YA9 4 YA20 5 YA39 6 YA39 met in the best possible way. Consideration should be given to producing a risk screening document to help staff identify all potential hazards that may be presented to people who live at the home so all control measures can identified and evaluated to ensure each individuals’ safety and well being. The medication policy, procedures and practices for the home should be reviewed and revised so staff have the guidance they need to ensure that medicines are administered, stored and recorded appropriately. The quality assurance processes for the home should be implemented, including conducting a survey of the views of the people who live at the home, their relatives and their health and social care professionals. The information obtained from them should be collated and a report on quality issues produced so the home continues to develop practices based on the views of the people who use the service and their representatives. Monthly management visits to the home should be carried out, (conducted by the responsible individual or an appointed representative who is not directly concerned with the conduct of the home), in accordance with the Care Homes Regulations so the way the home is being run is checked. Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Dee House DS0000006547.V351400.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!