Care Home: Dove House

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What the care home does well Dove House does well to ensure it provides prospective residents and their representatives with information about the home, it assesses if it can meet their needs and will support them to become familiar with their new surroundings and others living in the home by supporting regular visits prior to moving in. The home does well to support the residents using a person centred approach, respecting their wishes, decisions and aspirations. It encourages the residents to develop and maintain their independence, integrate into their local community and maintain contact with family and friends. A relative said: "The home supports my relative to take part in lots of activities which she never had an opportunity to do before she came to this home". Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 6The staff do well to ensure the physical and psychological needs of the residents are being met, providing the residents with support to access health care professionals such as GP`s, dentists, community pychatric nurses and psychologists and supports them with their medication. The home listens to the resident`s needs, wishes and concerns and acts promptly to deal with any concerns or complaints the residents or their representatives may have. Staff are trained to protect the residents and to inform someone immediately if they are concerned that they are at risk of harm. A relative said: " I have no concerns or complaints but if I am unhappy I know I can approach the manager and she will listen". Dove House offers a homely, safe and welcoming environment, which is spacious, tastefully decorated and furnished and offers individual bedrooms that are personalised and decorated to the residents liking. The manager and her staff are skilled and competent to meet the needs of the residents, they go through a thorough interview and induction process followed by mandatory training such as moving and handling and fire safety and specific training such as abuse awareness, managing challenging behaviour and epilepsy. A member of staff said: "They provide good training". The newly appointed manager brings with her specific skills that will benefit the residents and the smooth running of the home. The home has good systems in place for monitoring the quality of the service and develops an action plan that the manager and staff are responsible for meeting. The home undertakes regular health and safety checks, including checks on fire safety equipment, fire safety training for staff, checks on serviceable equipment such as moving and handlingequipment and checks on utilities such as gas and electrical appliances. What the care home could do better: No requirements or recommendation were made in respect of this visit to the home, however the registered individual (operational manager) was reminded that details on all staff must be present in the home including those that have transferred from other homes within the organisation. The operational manager confirmed that this would take place the day following the visit. CARE HOME ADULTS 18-65 Dove House Brewells Lane Rake Hampshire GU33 7HZ Lead Inspector Christine Walsh Key Unannounced Inspection 20th December 2007 10.00 Dove House DS0000068501.V344959.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 Dove House DS0000068501.V344959.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. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dove House Address Brewells Lane Rake Hampshire GU33 7HZ 01730 894841 01730 894841 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) Omega Elifar Ltd Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd March 2007 Brief Description of the Service: Dove House is a residential care home providing personal care and support for up to ten young adults with a learning disability. The home is located in a semi rural area between the towns of Liphook and Petersfield. Accommodation is provided in ten single rooms equipped with en suite facilities. Current fees start from £1,200 - £2,000 per week this includes day care provision. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit formed part of the key inspection process and was carried over one day by Mrs C Walsh, regulatory inspector. The manager completed an Annual Quality Assurance Assessment (AQAA) document, which was returned to the Commission for Social Care Inspection prior to the visit to the home. In addition “Have Your Say” resident and relatives comment cards were sent of which six were recieved. The information obtained to inform this report was based on viewing the records of the people who use and work at the service, speaking with a visitor and staff and observing care and support practices. A tour of the home took place and documents pertaining to health and safety were viewed. What the service does well: Dove House does well to ensure it provides prospective residents and their representatives with information about the home, it assesses if it can meet their needs and will support them to become familiar with their new surroundings and others living in the home by supporting regular visits prior to moving in. The home does well to support the residents using a person centred approach, respecting their wishes, decisions and aspirations. It encourages the residents to develop and maintain their independence, integrate into their local community and maintain contact with family and friends. A relative said: “The home supports my relative to take part in lots of activities which she never had an opportunity to do before she came to this home”. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 6 The staff do well to ensure the physical and psychological needs of the residents are being met, providing the residents with support to access health care professionals such as GP’s, dentists, community pychatric nurses and psychologists and supports them with their medication. The home listens to the resident’s needs, wishes and concerns and acts promptly to deal with any concerns or complaints the residents or their representatives may have. Staff are trained to protect the residents and to inform someone immediately if they are concerned that they are at risk of harm. A relative said: “ I have no concerns or complaints but if I am unhappy I know I can approach the manager and she will listen”. Dove House offers a homely, safe and welcoming environment, which is spacious, tastefully decorated and furnished and offers individual bedrooms that are personalised and decorated to the residents liking. The manager and her staff are skilled and competent to meet the needs of the residents, they go through a thorough interview and induction process followed by mandatory training such as moving and handling and fire safety and specific training such as abuse awareness, managing challenging behaviour and epilepsy. A member of staff said: “They provide good training”. The newly appointed manager brings with her specific skills that will benefit the residents and the smooth running of the home. The home has good systems in place for monitoring the quality of the service and develops an action plan that the manager and staff are responsible for meeting. The home undertakes regular health and safety checks, including checks on fire safety equipment, fire safety training for staff, checks on serviceable equipment such as moving and handling Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 7 equipment and checks on utilities such as gas and electrical appliances. 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. Dove House DS0000068501.V344959.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 Dove House DS0000068501.V344959.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 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does well to ensure the people who use the service are provided with information about the home in order to make a choice of where they would like to live. The home will ensure they can meet the needs of people who wish to use the service by carrying out an assessment prior to them moving in. EVIDENCE: The Annual Quality Assurance Assessment tool (AQAA) informed us that the home has a detailed Service User Guide and as a company they comprehensively assess potential service users prior to moving in. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 10 This was tested by viewing the homes Service User Guide, resident’s assessment documents, viewing a comment card and speaking with the manager and a relative. The Service User Guide has been produced considering the needs of the residents, it is clearly laid out, large and bold print and pictures have been used to support the written word. The Statement of Purpose is currently being reviewed and updated. The newly appointed manager stated she is skilled in using alternative communication aids and will be considering how the area of delivering messages to residents with communication, sensory and cognitive difficulties can be further improved upon. A relative said she had been provided with information about the home and having visited it felt it would meet her relative’s needs. The manager spoke of the process that would be used to assess and support the transition of a new resident to the home. This included undertaking a thorough assessment of their needs, meeting the prospective resident in their current home with their carers, encouraging them to visit the home with support of their carers building up to over night stays and requesting health care professionals such as occupational therapists, psychologists to get involved and undertake assessment if required. Three assessment documents were viewed and found to cover all aspects of the resident’s health and welfare, personal needs, and social, cultural and religious needs. A residents comment card confirmed that they felt the home could meet their needs. Dove House DS0000068501.V344959.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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does well to ensure the people who use the service have their needs met using an individual approach (person centred). They are supported to have a say about how they wish to receive their care and make decisions about their everyday lives. The risk to their health and welfare is minimised by using a risk management approach. EVIDENCE: The AQAA informed us that they have individual support plans developed from the assessment, residents are actively encouraged to participate and are consulted regarding all aspects of their lives Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 12 and risk assessments are in place to minimise the risk of harm. The home recognises what it could do better and how they are going to do this in the next six months such as improving the communication tools used in the home to encourage and enhance the opportunities fro residents to make choices. This was tested by viewing three residents personal plans, risk assessments, observing practice, speaking with the manager, where possible staff and residents, viewing comment cards and speaking with a relative. Each resident has a personal plan of their own which provides information on social interaction, health and mental health, personal care, communication, behaviours, mobility and daily notes. The care plans provide specific detail on how to support the residents and have been developed using a person centred approach, such as “needs assistance to run a bath”, “choose clothes” and “brush teeth” going onto explain how to do this in the way that the resident prefers. It was noted that this was different for each resident demonstrating that the home has considered the individual needs of the residents. The manager stated that the home is looking to improve upon the person centered plans to include the residents dreams, goals and aspirations. Each care plan is linked to a risk assessment and provides details of the risk and action required by staff to minimise the risks. The information was written in plain English and easy to follow. A relative said: “The staff here are very good, they seem to understand what my relative wants and look after her very well”. Three comment cards were received from the residents, indicating that they were assisted by staff and a relative to complete them: In respect of making decision’s two indicated always and another said sometimes. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 13 This was observed during the course of the visit where staff were observed to communicate with the residents in a way the resident understands and appear to comprehend what the residents was indicating through verbal and non-verbal prompts. It was observed during the course of the visit that residents are encouraged to make decisions about how they wish to spend their day, what activities they wish to engage in and making everyday choices such as what they would like to eat, drink and wear. This was also evidenced in the way the care plans are written, reminding staff to offer choices and listen to what the residents are communicating. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 14 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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does well to ensure the people who use the service are supported to maintain an active lifestyle that suits their needs and individual interests. The home does well to ensure the people who use the service maintain contact with family and friends and socially engage with their peers and the local community. The home does well to ensure the people who use the service have their rights respected, are provided with opportunities to make decisions and develop individual living skills. EVIDENCE: Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 15 The AQAA told us that the residents are encouraged to enjoy a full and active lifestyle, such as swimming, country walks, going to the pub, discos and cinema. However the service recognises where improvements are needed and have plans to improve these areas in the next twelve months such as supporting the residents to plan holidays and expand range of activities. The residents’ lifestyles were tested by speaking with the manager, observing activity in the home, viewing personal plans and speaking with a relative. Each resident has in their personal file an activity plan that identifies the activities they enjoy and a record of activities they have been involved in each day. The records included a number of activites which revolved around the festive season such as visiting a garden centre for lunch and view the Christmas decorations and shopping for Christmas presents. On the day of the visit which as previously stated was unannounced, there was a hive of activity, which included supporting the residents to participate in making Christmas decorations and making arrangements to support the residents to go shopping and a lunchtime pub lunch. The manager spoke of the range of activities the residents have recently been involved in which included community based activities such as shopping and visiting their local public house where they are well received by the local community and individual activities such as arts and crafts, cake making, hand massages and manicures. A relative said: “The home supports my relative to take part in lots of activities which she never had an opportunity to do before she came to this home”. A member of staff said: Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 16 “We provide an excellent service to the residents in supporting them to have regular outings and take part in planned activities of their choice”. A relative said: “My relative likes to join in activities she enjoys for instance shopping and discos”. The residents are supported to maintain contact with family and friends, on the day of the visit relatives of one of the residents were made welcome, invited to have lunch and spent time with the manager gathering information about their relative. A relative said “We are always kept informed of how our relative is, the staff are very good and when they can they will bring our relative to visit us. Another said: “My relative benefits from visiting home to see other members of the family”. The home supports the residents to have a say in their daily lives and to make decision, this was observed on the day with residents being encouraged to do things for themselves and make decisions about what they would like to do. Residents are encouraged to develop individual living skills such as doing, cleaning their bedrooms and preparing meals. Staff were observed interacting with residents in a respectful manner and supporting them to make choices about what they wanted to do. Three comment cards received from residents indicated that two were always supported to make decisions and choices and one indicated sometimes. The manager stated that the residents are involved in the planning and preparation of meals. The kitchen has low work surfaces to Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 17 accommodate residents who have limited mobility and need to sit to carry out such tasks. The manager went onto say that she is keen to introduce a healthy eating environment with fresh baked and home cooked foods. The dietary intake and the where required the weight of residents is monitored. The kitchen was observed to be clean, fully equipped and well stocked with dry and fresh foods. Residents who require support to eat their meals were observed on the day to receive support from staff in an unhurried and relaxed way. Personal plans provide staff with guidance on how to support the residents to eat, and identifies their likes and dislikes. Residents who have difficulty with eating and drinking are referred to specialists for support and advice. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 18 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 home does well to ensure the people who use the service receive the appropriate support with their personal care, health care and medication in the way in which they require and prefer. EVIDENCE: The AQAA informed us that the home supports residents to attend regular health care checks such as visits to the dentists, GP and specialist health care team and maintain good clear documentation of the use of medication and staff are trained. This was tested by observation, viewing three residents’ personal plans and medication records, speaking with the manager a member of staff and a relative. The personal plans provide detail on how the resident wishes to spend their day including, these are written in a way that reminds Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 19 staff of their roles and responsibilities in respect of offering and respecting choices and promoting and encouraging independence. An example of this observed on the day was respecting the resident’s wishes to have a lie in and encouraging them to eat their meal. A relative said: “Before my relative moved to this home she was unable to do most things for herself, but the home has been very good and patient with her to encourage her to develop skills that she didn’t have such as drinking out of a cup”. Personal plans provide information on the residents’ specific health care needs, what action is required and how staff must attend to these health care needs. The manager stated that the home has good links with primary care and specialist health care teams. Personal plans demonstrated that the health care needs of the residents are regularly monitored and reviewed. At the time for the visit a health care professional was visiting the home to observe the behaviours of a resident. The manager went onto say that they have had regular contact with behavioural specialists to support them to understand and appropriately support the resident. Behavioural monitoring records are in place and up to date. At the time of the visit the home was making arrangements with a consultant in respect of the residents medication. This was observed to be done efficiently and clear records were kept, including a faxed letter from the consultant. The home has systems in place for the administration of medication. The home uses a monitored dossett system which is supplied by a well-known high street pharmacy who also provide training for staff. Medications are received, stored, recorded and disposed of using systems as stipulated in the Royal Pharmaceutical Guidelines. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 20 Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 21 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. The home does well to listen to and act upon the concerns raised by the people who use the service. The home does well to ensure the people who use the service are safeguarded from potential risk of harm. EVIDENCE: The AQAA informed us that the residents feel supported and protected from abuse, neglect and self-harm. Staff are aware of the complaints procedure and appropriate policies are in place. The home recognises that not all residents are aware of their rights and understand the complaints procedure and plans to in the next twelve months to address this. This was tested by viewing the complaints procedure, logbook and the homes quality assurance audit, speaking with residents, staff, a visitor and the manager. The complaints procedure details how the people who use the service can make a complaint and what action must be taken to resolve a complaint. The home encourages open dialogue with Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 22 residents and relatives, holding regular meetings with the residents and spending time with relatives sharing information. Three residents indicated on their comment cards that they knew who to speak to if they are unhappy and two indicated that they knew how to make a complaint. Three comment cards recieved from staff indicated that they know what to do if they received a complaint. It was identified by one member of staff on the comment card that the home could do better to introduce better communication aids for some of the residents. A relative said: “ I have no concerns or complaints but if I am unhappy I know I can approach the manager and she will listen”. The manager spoke at length regarding her skills in this area and her plans to introduce individualised communication aids to assist residents and staff to communicate better. The complaints log provided evidence as stated in the AQAA that the home has not received any complaints in the last twelve months. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 23 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, 25, 29 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 does well to ensure that the people who use the service benefit from a comfortable, safe, spacious and clean home, which has been decorated and equipped to meet their personal and physical needs. EVIDENCE: The AQAA informed us that the home is The home has been redecorated to a high standard and the Service Users were consulted about their choice of colour décor and furniture. The home is always clean and supports a happy, calm atmosphere. Responses from Service User friends and families to quality questionnaires has yielded positive feedback. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 24 This was tested by touring the building, viewing a residents bedroom which wasn’t being used currently, speaking with the manager and a relative. The home is located in a semi rural area between the towns of Liphook and Petersfield. The communal areas are spacious, homely and decorated and furnished to the specification and needs of the residents, all who currently need assistance with their mobility. The home has an idyllic outlook onto the surrounding countryside, which is seen from French windows in the lounge and a spacious veranda that has been finished off with raised flowerbeds and areas of shade for the residents when the sun is out. The home was observed to be relaxed and residents were seen to be settled and comfortable. A resident’s bedroom, which is currently not being used, was seen and this had been personalised by the occupant. All residents’ bedrooms are equipped with en suite facilities. Hold-back/release devises were fitted to fire doors so as to enable service users easy access to communal areas. A bath had been modified to allow a hoist to be used. The kitchen is fitted with a height adjustable table to enable service users to take part in preparing meals and overhead tracking devices for moving and handling are fitted in each residents bedrooms. The home was clean and tidy and there were no unpleasant smells. The AQAA informs us that the home has infection control procedures and currently two staff have received training in infection control. The home is advised to work towards all staff recieving this training. Staff are provided with protective clothing such as gloves and aprons and liquid soaps and paper towels are available in bathroom and toilet facilities. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 25 The home has laundry facilities that meet the needs of the numbers and needs of the residents, in addition there is facilities for the residents to carry out their own laundry if they wish. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 26 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): 32, 33, 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. The home does well to ensure the people who use the service benefit from well-supported, competent and qualified staff. The home does well to ensure staff are trained and a thorough staff recruitment process is in place to promote the safety of the people who use the service, however the home must ensure that records of staff transferring from other homes within the organisation are placed in the home that they have moved to. EVIDENCE: The AQAA informed us that it does well to ensure the Service Users are supported by competent and qualified staff, that they are supported and protected by the company recruitment policy and procedures. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 27 This was tested by viewing the duty rota, training records, staff recruitment files, observing care and support practices, speaking with a relative and viewing comment cards received from staff and a relative. At the time of the visit there were three members of staff rotered on duty throughout the day plus the manager and two staff on waking night shifts to support three residents. The current needs of one resident require they receive one – to – one support when they are up and awake and additional support at night. The home has made allowances for this and it has enabled them to continue meet the needs of other residents living in the home. The home was observed to be relaxed and staff went about supporting the residents in a relaxed and unhurried manner, spending time with the residents in various activities. Two comment cards received from staff indicated that they usually have enough staff on duty and another indicated that they always have enough staff on duty. Following the last visit to the home it was issued with a requirement to ensure that care staff levels in the home are increased to ensure that all residents personal, health and social needs are met in a safe way at all times. It has been demonstrated throughout the body of this report that the home has met this requirement. The relative who was met with at the time of the visit said, she couldn’t fault the staff: “They work so hard and are always friendly and welcoming”. The home supports and encourages its staff to undertake a national vocational qualification (NVQ), the home currently has 40 of its staff trained in NVQ. The home is reminded that it must work towards 50 obtaining an NVQ. A member of staff said: “They provide help and advice on NVQ’s”. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 28 Three staff recruitment records were viewed to establish if a robust procedure has been used in the recruitment process. The records provided evidence that an application had been completed, an interview had taken place, references had been applied for before commencing in the home and criminal record bureau (CRB) and protection of vulnerable adults (POVA) checks have taken place. There was evidence however that two members of staff that had transferred from another home within the organisation did not have their records in place, the service development manager admitted that this was an oversight and arrangements would be made for one persons staff records to be transferred immediately, guaranteeing that it would be in the home the next day. With respect to the other member of staff the service development manager was reluctant to allow the file to be transferred until such time the member of staff’s position in the home had been clarified. The manager was advised of the registered person/s legal responsibilities and requirements in respect of regulation 17(2) Schedule 4. Staff receive required training such as moving and handling, first aid, fire safety and food hygiene, in addition they receive training specific to the needs of the residents such as epilepsy, managing challenging behaviour, medication and communication and looking at individual communication styles is to be introduced in the near future. Of the three comment cards received from staff two said they received good training, which enables them to support and understand the needs of the residents. A member of staff said: “They provide good training”. The manager spoke at length of the induction process they have for new permanent staff and agency staff, which includes orientation of the home, familiarising themselves the residents and their specific needs, working with staff and being shadowed by a senior and Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 29 undertaking training within a specific timescale that is in line with “Skills for Care” guidance. There is evidence that the manager is working towards providing regular and structure support and supervisions session for staff, has an open door policy and regularly meets with staff at handovers and planned meetings to discuss current issues and concerns. This was evidenced by viewing documentation, minutes of meetings and comments made by staff. All three staff who sent in a comment card indicated that they are always supported and that they are regularly supervised. A member of staff said: “They provide good support to staff and service users in times of need”. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 30 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 home does well to ensure that the people who use the service benefit from a well run home, its ethos and management and leadership skills of the manager. The current manager must make an application to become the Registered Manager. The home does well to ensure quality-monitoring systems used in the home benefit the people who use it. The home does well to ensure the people who use the service are provided with a safe place for them to live in. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 31 EVIDENCE: The AQAA informed us that the home is maintained in accordance with the National Care Standards, the service users rights and best interests are safeguarded by the homes policies and procedures and the health and safety of the service users is promoted and proteceted. This was tested by spending time speaking with and observing the newly appointed managers leadership skills and interactions with residents, staff and relatives. Speaking with and seeking the views of visiting relatives, viewing fire records and other service certificates and viewing comment cards. The service has recently recruited a new manager to the home, who is planning to register in the New Year and is working towards a Registered Managers Award (RMA). The manager brings with her many years experience of working in the field of supporting people who require assistance with communication and using other senses to live fulfilled lives. The manager demonstrated through the course of the day that she has a good understanding of the needs of people with learning disabilities and her roles and responsibilities in ensuring their needs are appropriately met. A member of staff spoken with at the time of the visit said they felt well supported by the manager. A relative said: “The manager is very kind and helpful, I have no worries approaching her with any concerns”. The home undertakes a quality audit of the service seeking the views of the residents and relatives, this incorporates the national minimum standards such as relationships, respect, care practices health and safety. In addition monthly resident and staff meetings take place and the home is visited once a month by a senior Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 32 manager in the company who undertakes an unannounced quality audit of the home (regulation 26) which looks again at the national minimum standards including viewing number of complaints and incidents that require the Commission for Social Care Inspection to be notified of (Regulation 37) This provides the manager and staff team with a clear audit of how they can continue to improve on the quality of care and support. There are safe systems in place for fire safety. Staff receive regular training and regular checks are made on fire safety equipment. Corrosive substances hazardous to health (COSHH) are securely locked away, there are notices discreetly displayed around the home reminding people of good hygiene practices and all serviceable utilities including small electrical appliances are regularly checked to ensure they are in goods working order. Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 33 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 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 Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 34 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 35 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Dove House DS0000068501.V344959.R01.S.doc Version 5.2 Page 36 - 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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