Care Home: Doric View Short Break Service

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What the care home does well Information about the service at Doric View is written in a book called the Service User Guide. This clearly gives information about the service and has good photographs of different parts of the building so that people can see what it is like inside. People are also invited to look around the house. This helps people to make a decision about whether they want to stay there for a holiday. It is very comfortable inside Doric View, there is good furniture and the rooms are nicely decorated. It is well looked after and kept very clean and tidy. Some of the staff have worked at Doric View for many years and know the guests very well. All of the staff are taught how to support and care for people with disabilities. This means that guests receive the right support. The friendliness shown between guests and staff is clear. The manager can make special arrangements for friends to enjoy a holiday together. She always tries to arrange it so that people who get on well together stay at the same time and enjoy each other`s company It was good to see people that know each other well and have similar interests enjoying their weeks break together. Staff work hard to ensure that whenever possible this is arranged. In addition to this staff work hard to introduce guests to new people so that new friendships can develop. To enable this guests are supported to attend friendship groups in different areas with the aim that their attendance will continue after their stay at Doric View. The amount of space and the handrails provided in Doric View allows guests to safely move around independently. One guest was delighted how they could manoeuvre their new electric wheelchair skilfully around the building. Staff ask guests if there is anything special that they want to do while on holiday at Doric View. Staff also support guests to try different activities and so that their family at home know, where they have been and what they have done, staff help guests to write what they do each day in a diary. So that staff know how guests like to be supported with things that they cannot do themselves, guests and their carers at home help staff to write down instructions for staff to follow. These are called care plans. Staff follow instructions written in the care plans that tell them how to keep guests safe, so that they can enjoy activities that they choose or that staff might think they will enjoy. Guests receive a good variety of food that is served to them in a way that they can manage and prefer. There is special equipment in Doric View that gives support to guests who need it to move around and to enjoy a bath safely. The bathrooms are beautifully decorated and the baths are equipped with spas that add enjoyment and comfort to the bathing experience. Relatives made the following statements in the service `s surveys: "I find management and staff very helpful and friendly." "I am highly satisfied with the care X receives." "The service is great everyone tries to make X happy and content." What has improved since the last inspection? The information provided in the Statement of Purpose and the Service User Guide has been reviewed and updated. This means that people get a good view of what the service provides when reading it. Some areas of the house have been decorated and new furniture; carpets and furnishings have added interest and comfort to the environment. This means that guests stay in attractive, interesting and safe surroundings. Both bathrooms have had new baths and lifting equipment fitted to make it easier for people with different physical needs to bathe comfortably and safely. Both baths can be moved up or down so that staff can support people to bathe safely and comfortably without straining their backs. This also makes it safer for the person bathing. One bath, that also tilts, is shaped so that people can be supported independently and both have jet spas that can add enjoyment to the person`s bathing experience. A walk in shower gives guests a choice of whether to use the bath or not and overhead hoists improves their safety and promotes their dignity. What the care home could do better: The manager should make sure that there always enough staff on duty to assist guests with their personal care needs and to help them to enjoy different activities while they are staying at Doric View. CARE HOME ADULTS 18-65 Doric View Short Break Service Station Road Penshaw Sunderland DH4 7LB Lead Inspector Elsie Allnutt Key Unannounced Inspection 12th August 2008 9:30 Doric View Short Break Service DS0000032749.V370417.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 Doric View Short Break Service DS0000032749.V370417.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. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Doric View Short Break Service Address Station Road Penshaw Sunderland DH4 7LB 0191 382 3063 0191 382 3064 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) Council of City of Sunderland Mrs Julie May Cartwright Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Doric View Short Break Service DS0000032749.V370417.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: 6 The maximum number of service users who can be accommodated is: 6 4th September 2007 Date of last inspection Brief Description of the Service: Doric View is a short break service operated by City of Sunderland Social Services Department which provides planned breaks for both men and women with learning disabilities, between the ages of 18 and 65 years, and who are dependent upon carers for care and support. The level of service provided depends on the needs of the individual but does not exceed 56 nights in one year. Doric View is situated just outside the village centre of Penshaw within easy reach of shops and local transport. The aim of the service provided from Doric View is to deliver a service as near to a holiday experience as possible during which time staff support service users to take part in community-based activities. The house is a purpose built bungalow and was constructed in 1996 and is owned by Three Rivers Housing Association who retain responsibility for the maintenance of the property. It has space and facilities to accommodate people who use wheelchairs and provides single bedrooms with a lock and key for all service users. There are also adaptations and equipment to meet the needs of people with physical disabilities. A garden and patio is also available for the people using the service. The home has developed a Service User Guide that informs prospective service users about the service, the aims and how these are met. A copy of the recent inspection report is available in the home for anyone to read. The fees paid by the service user is £103 per week. Doric View Short Break Service DS0000032749.V370417.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 2 star. This means the people who use this service experience good quality outcomes. Before the visit: We looked at: • Information we have received since the last visit. • 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 Visit: An unannounced visit was made on 12th August 2008. During the visits we: • • • • • • Talked with people who use the service, 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 parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the manager what we found. What the service does well: Information about the service at Doric View is written in a book called the Service User Guide. This clearly gives information about the service and has good photographs of different parts of the building so that people can see what it is like inside. People are also invited to look around the house. This helps people to make a decision about whether they want to stay there for a holiday. It is very comfortable inside Doric View, there is good furniture and the rooms are nicely decorated. It is well looked after and kept very clean and tidy. Some of the staff have worked at Doric View for many years and know the guests very well. All of the staff are taught how to support and care for people with disabilities. This means that guests receive the right support. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 6 The friendliness shown between guests and staff is clear. The manager can make special arrangements for friends to enjoy a holiday together. She always tries to arrange it so that people who get on well together stay at the same time and enjoy each other’s company It was good to see people that know each other well and have similar interests enjoying their weeks break together. Staff work hard to ensure that whenever possible this is arranged. In addition to this staff work hard to introduce guests to new people so that new friendships can develop. To enable this guests are supported to attend friendship groups in different areas with the aim that their attendance will continue after their stay at Doric View. The amount of space and the handrails provided in Doric View allows guests to safely move around independently. One guest was delighted how they could manoeuvre their new electric wheelchair skilfully around the building. Staff ask guests if there is anything special that they want to do while on holiday at Doric View. Staff also support guests to try different activities and so that their family at home know, where they have been and what they have done, staff help guests to write what they do each day in a diary. So that staff know how guests like to be supported with things that they cannot do themselves, guests and their carers at home help staff to write down instructions for staff to follow. These are called care plans. Staff follow instructions written in the care plans that tell them how to keep guests safe, so that they can enjoy activities that they choose or that staff might think they will enjoy. Guests receive a good variety of food that is served to them in a way that they can manage and prefer. There is special equipment in Doric View that gives support to guests who need it to move around and to enjoy a bath safely. The bathrooms are beautifully decorated and the baths are equipped with spas that add enjoyment and comfort to the bathing experience. Relatives made the following statements in the service ‘s surveys: “I find management and staff very helpful and friendly.” “I am highly satisfied with the care X receives.” “The service is great everyone tries to make X happy and content.” What has improved since the last inspection? Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 7 The information provided in the Statement of Purpose and the Service User Guide has been reviewed and updated. This means that people get a good view of what the service provides when reading it. Some areas of the house have been decorated and new furniture; carpets and furnishings have added interest and comfort to the environment. This means that guests stay in attractive, interesting and safe surroundings. Both bathrooms have had new baths and lifting equipment fitted to make it easier for people with different physical needs to bathe comfortably and safely. Both baths can be moved up or down so that staff can support people to bathe safely and comfortably without straining their backs. This also makes it safer for the person bathing. One bath, that also tilts, is shaped so that people can be supported independently and both have jet spas that can add enjoyment to the person’s bathing experience. A walk in shower gives guests a choice of whether to use the bath or not and overhead hoists improves their safety and promotes their dignity. 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. Doric View Short Break Service DS0000032749.V370417.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 Doric View Short Break Service DS0000032749.V370417.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Guests are given up to date information about the home and good multidisciplinary preadmission assessments demonstrate guests’ needs and aspirations and assist the service to make an informed judgement as to whether they can meet these. EVIDENCE: The Statement of Purpose and Service User Guide have been reviewed and adjusted to reflect the service that is delivered. Guests are given a copy of the Service User Guide and a contract that they sign so that they are aware of what services are offered and what is expected of them during their stay. Prior to a person being offered a service, a full assessment of need is carried out. Assessments from referring agencies and health care professionals are included in guests’ care files. Assessments carried out by the service during visits to individual guests’ homes are also included and all clearly state the guest’s assessed needs and what they personally require from the service. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 10 As well as information about an individual’s care needs and how they need to be supported, detailed information about their background, family history, important events and people in their life and the sort of activities they prefer, are also included in the preadmission assessment process. The activities guests took part in reflected the aspirations they had discussed with staff during the assessment process. Any risks identified in the assessment process are included in the individual plan of care. If any guest has their rights limited due to lack of capacity, this is identified in the assessment process and recorded in the care plan. For example, the support needed with personal money and the administration of personal medication. All are monitored and reviewed appropriately. This service also plays an important role in the work currently going on to support young adults going through the transition process of moving from children’s to adult’s services. Staff attend multi disciplinary assessment meetings to discuss the opportunities the service has to offer and the resources available to meet the individual’s needs. This helps this service to plan the resources needed for future guests. Individual contracts signed by the individual guest are in place and describe the terms and conditions of the service. The document has been developed into picture format and this enables guests to have a better understanding of the content. Doric View Short Break Service DS0000032749.V370417.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans that are the outcome of assessment and that are lead by the guest, guide staff to appropriately support guests’ care needs, promote their independence by safely addressing risks and enable staff to support guests to make choices about their lives. EVIDENCE: There is a care plan in place for each guest staying at this service. The information recorded in them is current and clearly guides staff to effectively address the individual guests’ personal, social and emotional care needs. Guests are empowered to lead their care plans. They are written with a person centred approach and illustrated with pictures so that guests have access to what is written about them. The care plans give good detail about the individual person and their needs and the information in them guides staff to support guests in their preferred Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 12 way. One describes how the guest prefers to be supported and details guide staff to use the special appliances needed when bathing. A list of likes and dislikes assist staff to help the person to make choices about their life. Although knowing the daily routines individuals enjoy it is also important that this sort of service has information about the guests preferred social activities. Information in the care plans includes this and specific detail helps staff to support guests in their decision making by offering and arranging activities and new experiences that the person will enjoy. Some statements made by guests include: “I enjoy noisy theatre shows.” “I like a massage.” “I like to listen to classical music.” Risk management strategies guide staff to safely support guests in daily living routines and activities of their choice and by following the guidelines in place the guests are supported to achieve these independently and safely. Risk assessments have been carried out and guidelines for staff to follow to reduce the risks are in place in relation to the use of bedrails, the covert administration of medicines and the use of a belt while using a wheelchair. All include good detail and are signed. Although the care plans are monitored daily and updated when needed, they are usually reviewed annually, jointly with the individual’s primary care service. This is usually the day centre where the manager or a representative from the short break service contributes to the meeting by giving feedback relating to the outcome and effects of the short break service and how this contributes to the individual’s life. Doric View Short Break Service DS0000032749.V370417.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. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Although the people who use the short break service at Doric View often have complex needs, an enthusiastic staff team successfully promotes their right to choice and to live a normal and an active life, however often the lack of staffing resources has compromised this. Wholesome food is provided so that guests receive a balanced and healthy diet that is individual to their needs. EVIDENCE: The needs of the guests staying at this service have become increasingly complex and this has put an increasing strain on the original number of staff allocated to work here. It has therefore become increasingly difficult for staff to fully address the level of activity that this service promotes. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 14 Staff get to know the guests well before they stay at this service and with this knowledge they interact and support individuals in a way that motivates and addresses their personal preferences. As a result of this guests are supported to make individual choices and decisions about the life they wish to live while at Doric View. Guests are encouraged and supported to take part in a wide range of leisure activities in the community for example outings to pubs, restaurants, the cinema, theatre, swimming, shopping trips and visits to different places of interest. Due to the high needs of the guests that stay here not everyone can go out at the same time or on the same day, all guests therefore at some time spend time at home. Although this is explained to guests before their stay and it is stated in the Statement of Purpose, some guests are disappointed that they are unable to make spontaneous decisions to go out for walks etc. Two members of staff supported three of the six guests to enjoy a day trip out at a planned destination and the remaining three, all who use wheelchairs stayed at home with the remaining two members of staff. It was good to note that two of the guests were good friends and enjoyed their time together chatting and the third guest who was familiarising themselves with their new surroundings, it being their first stay at the service, enjoyed listening to music. Although the number of staff on duty limited the choice of activities to take place the staff used their time effectively so that they gave some form of choice to all guests at some part of the day. There were plans in place for other guests to go swimming and to a disco later that afternoon when more staff would be available which gave guests something to look forward to while staying at home. More than one of the guests stated that they like it at Doric View because they can stay up late. A varied menu is available in the home that reflects the choice of the individual guests. Care plans include a list of individual guests’ food and drink preferences and those they dislike. This information also includes instructions on how an individual guest likes and needs their food served and the sort of crockery and cutlery needed. There are several different areas around the building with dining facilities that accommodate guests’ diverse needs and choices, allowing the choice to eat with friends in a social situation or in a more private and quiet way. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 15 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Guests receive personal support appropriate to their needs and in a way that enables their privacy and dignity to be respected. Extended overhead tracking systems and refurbished bathrooms have provided advanced and up to date facilities and appliances that ensure safer and improved practices for both guests and staff. The medication arrangements in place are appropriate to guests’ needs. EVIDENCE: The people using the service are temporarily registered with a local GP during their stay at Doric View if they are from outside their local areas, who are called upon if and when needed. As most of the guests needs are becoming increasingly complex, to address this staff work closely with healthcare professionals that may be involved in a person’s life and details of this are recorded in the individual plan of care. When needed visiting community nurses visit the service to carry out nursing tasks. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 16 As this is a respite service and guests are seen to be “on holiday” the service supports guests to medical appointments during their stay, only as a special request and if the service is confident that they have all the necessary information. Care plans guide staff to support guests with personal tasks in their preferred way and the details recorded ensure that this is achieved by using mobility appliances safely, that reflects good practice and in a way that make guests feel safe. Guests stated that staff support them in the way that they like and in a way that is respectful and that promotes their dignity. The appliances in the home have been greatly upgraded since the last inspection. Extended overhead tracking systems and improved bathing facilities now appropriately address the needs of the people who use this service. These appliances play an important part in promoting service users’ dignity and independence as well as promoting the safety of both service users and staff. All of the special appliances are regularly maintained so that they are safe for use. Staff have received training in the administration of medication and their knowledge and the way medication is stored reflects this. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 17 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements that are in place help protect guests from abuse and to seriously address complaints and concerns about the service. EVIDENCE: The service has a comprehensive complaints procedure that is in picture format in an attempt to make it more accessible to the service users. The guests are informed of the procedure at the beginning of every stay and complaint forms are kept in each bedroom. Staff are aware of signs given by guests when they are not happy or are showing concern about something. This is addressed directly on a daily basis and also at the end of guests’ stay. A log at the beginning of the file records all complaints made and their outcome. Reports of complaints made are addressed and recorded appropriately. Relatives made the following statements in the service’s surveys: “I always express my concerns regarding my X and feel the concerns raised are dealt with accordingly.” “All complaints made have been dealt with quickly.” “Concerns and complaints are always treated as a priority and every effort is made to deal with them appropriately with the problem.” Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 18 The home follows the local authority’s policies and procedures in relation to Safeguarding Adults. Staff receive training in relation to this and they are aware of the appropriate action to take in a situation if they were to witness abuse or have an incident reported to them. A copy of the local authority’s safeguarding adults procedure is available within the home, to guide staff on the procedures to take. Staff have received training in relation to Verbal and Physical Aggression and are consistent in how challenging behaviour is to be approached. The approach is consistent with guidelines in individual care plans. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 19 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): 24,27,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Guests are provided with an environment that is homely, comfortable, clean and decorated and furnished to a high standard. Improvements to environmental adaptations and disability appliances, with particular note to the bathrooms, mean that the diverse and often complex needs of guests are met in a dignified and comfortable way, while at the same time their safety and that of staff is promoted. EVIDENCE: A good maintenance programme promotes the high standard of décor and furnishings throughout this building. Different parts of the building have been decorated and new furniture and tasteful small furnishings have enhanced the appearance and comfort for guests to enjoy. This is particularly the result of the staff team working together, getting to know the needs and likes of the service users and having a genuine commitment to meeting the aims and objectives of this service. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 20 Each bedroom is individually decorated and has good quality furniture and small furnishings that coordinate with the décor. Overhead tracking devices and profile beds offer the special facilities that many guests need to promote their comfort, dignity and safety. The three lounges give guests the chance to be with others or to find a quiet space for privacy. Large screened TVs, play stations and musical equipment provide activity for guests when at home. A member of staff, who is a valued member of the staff team, is employed to deal with domestic tasks within the home, however she also plays an important role in the advising and decision making of décor and furnishings. The cleanliness of the environment reflects the effective cleaning routines in place. Both bathrooms have recently been refurbished and now provide the special facilities needed by guests with often, complex physical needs. Overhead tracking devices and specialised baths that can be adjusted to different heights, approached from two sides and one that tilts promotes the comfort and safety of both guests and staff. So that these areas are attractive and offer a “warm” atmosphere they have been thoughtfully decorated and furnished with coordinating fixtures and furnishings that provide bright and inviting places to enjoy a relaxed bathing experience. The building is surrounded by attractive gardens. Colourful flower tubs surround the entrance area and strong patio furniture allows for outside dining and barbecued meals. The high standard throughout this environment promotes a positive image of the people who stay and work in this service. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 21 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): 33,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Regular training opportunities and good recruitment procedures ensure that guests are appropriately supported and protected by a competent qualified staff team who are committed to their role. However the number of staff on duty is not always sufficient to promote “a holiday type experience.” EVIDENCE: There are at least three members of care staff on duty each day. In addition to this the manager or deputy and a domestic who works mornings, are also available. The domestic member of staff is also trained as a carer and at times works in this role. Since this service opened the needs of the people using it have changed. Guests staying for holiday/respite purposes have more diverse and complex needs, which for some time has put increasing strain on the staffing resources available. The current staffing number is not sufficient to address both the increasing needs of guests and the aims and objectives of the service. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 22 It is good to note however that the manager has recently reviewed the number of staff needed for this service and has requested that the staffing numbers are increased by three. The local authority is currently addressing this request and in the meantime two new members of staff will be seconded to work at Doric View starting in September and at the beginning of October. This will be a temporary arrangement until the final agreement is made and permanent staff are employed. Staff interact with guests in a respectful and sensitive manner and clearly demonstrate that they have the appropriate skills and knowledge relating to the guests’ needs. The majority of staff who work at this service have done so for a many years, they therefore know many of the guests well and have been instrumental in the development of the service. They use their initiative well and use their own interests to encourage and lead guests to be involved in new experiences. One member of staff’s keen interest in photography means that guests have a diary, illustrated with photographs, of their stay at Doric View that they can share with their family and friends on their return home. Another person’s interest in technology has helped the service to purchase entertainment equipment for the home that meets the diverse needs of the guests, for example televisions that can be mounted on to the walls. Staff receive a good and varied training programme that offers appropriate opportunities to develop and learn skills related to their role. The majority of staff are trained in NVQ 2 and above. Robust recruitment procedures are followed and guests are involved during this process. Although they are not involved at the interviewing stage their views about employees are taken seriously and into consideration before a new employee’s probationary period comes to an end. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 23 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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager, who is well supported by the staff team, provides a service that is well run, safe, and focussed on the best interests of the service users. EVIDENCE: The manager was unavailable during this inspection however the inspection process was competently accommodated by the deputy manager who was in charge of the home at the time. A telephone conversation took place with the manager following the inspection. The manager is fully qualified and has a wealth of experience managing services and working with people with learning disabilities. She has a Diploma in Management, NVQ 4 in Care and the A1 Assessors Award. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 24 Effective relationships have developed between guests, staff and the manager. The manager and the deputy show commitment to her roles and attend regular training regarding these. There is a clear administrative system that supports a well run home. Records are accessible, clear and stored securely. The policies and procedures are regularly reviewed and brought to the attention of the staff team during staff meetings that also regularly take place with minutes recorded. Supervision sessions with individual staff are planned and recorded. There are systems in place to monitor the effectiveness of the service provided and service user surveys carried out by the service confirms that this is achieved with the best interests of the guests in mind. Records in the fire and accident books were satisfactory. Health and safety procedures are in place and staff practices reflected their knowledge of these. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 25 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 3 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 4 25 X 26 X 27 4 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 26 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 YA33 Good Practice Recommendations It is strongly recommended that the plans in place to improve the staffing resources should go ahead. Doric View Short Break Service DS0000032749.V370417.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Doric View Short Break Service DS0000032749.V370417.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. 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