Care Home: The Dell

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What the care home does well The Dell provides a comfortable, well kept and homely environment for people to live in. Residents enjoy living there and are involved with the running of the home. Staff are competent and well trained. They understand the varied needs of the residents and provide the support they need. Residents are able to make choices in their lives and take acceptable risks. Care plans are thorough, personalised and detailed. What has improved since the last inspection? Since the last inspection the home has been redecorated throughout. Residents were involved in making choices about the new decoration in the communal areas of the home as well as in their own rooms. Care planning has become more person centred and the variety of activities for residents has been improved. There is now a registered manager running the home. What the care home could do better: No requirements have been made following this inspection. The Dell should continue to provide good quality outcomes for residents and continue looking for ways to improve the service. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Dell 7a Kithurst Close Southgate Crawley West Sussex RH11 8TD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jo Hartley     Date: 3 0 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: The Dell 7a Kithurst Close Southgate Crawley West Sussex RH11 8TD 01293561234 P/F01293561234 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Evesleigh Care Homes Ltd (ILIACE Group) Name of registered manager (if applicable) Mr Alex Cullum Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 4. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home The Dell is a care home registered to accommodate up to four Service Users with learning disabilities. The Registered Provider is Evesleigh Care Homes Ltd and the Registered Manager is Mr Alex Cullum. The home is a detached property in a cul-de-sac. It is situated within the town of Crawley, which has community facilities and rail and bus links. Care Homes for Adults (18-65 years) Page 4 of 26 care home 4 Over 65 0 4 Brief description of the care home Accommodation is provided over two floors. Each resident has their own bedroom, with a bedroom located on the ground floor, and the remaining three rooms on the first floor. On the ground floor there is a kitchen that includes a dining area and utility room. In addition there is a nice size living room that leads into a office. Outside, to the rear of the property there is decking and flowerbeds. The Service Users Guide and Statement of Purpose, which incorporates inspection reports, are both located at the home and are accessible to residents, staff, relatives and anyone else interested in the service. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people that use this service experience good quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These include: previous reports of visits to the home, the Annual Quality Assurance Assessment (AQAA) completed by the home, an unannounced visit to the home, which was carried out on the 30th July 2009 and discussions with residents and staff. During the visit we looked at the homes policies and procedures, staff records and residents records. All regulatory activity since the last inspection was reviewed and taken into account Care Homes for Adults (18-65 years) Page 6 of 26 including notifications sent to the Commission for Social Care Inspection, (prior to 1st April 2009), and the Care Quality Commission, (from the 1st April 2009). The last inspection on this service was completed on the 10th July 2007. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents needs and aspirations are assessed prior to moving into the home. Evidence: There are currently three people living at The Dell. There have been no new admissions since the last inspection. We looked at the pre-admission assessments for two residents and found them be thorough. The assessments include details of the persons background, physical and mental health, daily living and personal care needs, social and educational needs, communication, relationships, cultural/spiritual needs, and dietary needs and preferences. Equality and diversity issues are addressed throughout all of the assessments. Each resident has an individual statement of terms and conditions regarding living at the home. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have individual service user plans. Potential risks have been identified and minimised as far as possible. Residents are involved in all aspects of life in the home. Evidence: The care plans that we saw during the visit were detailed and person centred. Individuals needs and how they will be met by the home are clearly documented. Each person has a My Life Plan which has sections such as; Who I Am, People I Like to Stay in Contact With, My Daily Routine, Ways in Which I Communicate My Feelings, and What I Need to Stay Healthy. Other sections cover likes, dislikes, risk assessments, medication, future plans and daily routines. Care plans detail not only what assistance people require but also what they are able to do themselves. For example, I can get my own breakfast if I have fresh fruit. I need help if I have cereal or a cooked breakfast. We saw evidence that residents and their families are involved in care planning and reviews. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: Each resident has individual and health and safety risk assessments. These include, where appropriate, self harm, aggression, abuse, absconding, medication, fire safety self neglect. Risk assessments describe the risk, consequences, controls in place and an action plan. Residents are involved in the running of the home. They told us have regular meetings with the staff and the Manager and they get to say what they would like on the menu or what activities they would like. They are also involved in food preparation, doing laundry and tidying up around the home. Throughout the visit staff were seen supporting residents in making choices. One resident did not want what was on the main menu for dinner, a member of staff told him what other choices were available so he could make a decision about what he would like instead. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to be involved in appropriate activities. Relationships are maintained with family and friends. The home promotes healthy eating and provides a varied diet. Evidence: Each resident has an individual activity plan that sets out what activities they like to take part in. Activities include attending college, workshops, clubs, drama, shopping, crafts and sports. During the visit one resident was being assisted in planning and buying things for a fishing trip. The home has its own transport to enable residents to take part in outings and community activities. All the residents have been on holiday this year. Another resident has recently bought a train set and was being supported in having a Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: table made so he can set the track up in his bedroom. We could see from the records we looked at that residents are able to maintain relationships with their families and friends outside of the home. One resident told us that his mum was going to visit him at the weekend. Two residents told us that they are able to help choose the menu for the week and assist staff with shopping for food. There is a board in the kitchen with the weeks menu on it. When we arrived at the home one resident was cooking the evening meal with assistance from staff. Another resident wanted something different and was supported in choosing another option. A member of staff said residents can make quite limited choices in what they want to eat so staff encourage them to try different meals such as curries and stir fries to widen their taste and experience. Meals are varied and include fresh vegetables. There were bowls of fresh fruit in the kitchen for residents to help themselves to. Residents have their own keys to their rooms so they are able to lock them if they wish. One resident told us that he likes to lock his door when he is not in the home. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive personal support in an appropriate manner. Residents physical and emotional needs are met. Suitable procedures are in place in respect of the administration of medication. Evidence: Each of the residents at The Dell have two named keyworkers to ensure consistency and continuity of support. Any assistance needed with personal care is clearly documented in individual care plans and includes information on what people can do for themselves as well as what they need support with. Two residents told us that they are able to choose what they want to wear every day. Each resident has an individual Healthcare Action Plan. Evidence in residents health files show that they receive additional healthcare support, e.g. from psychiatrists, opticians, speech therapists, continence advisors, dentists and general practitioners when it is required. A record is kept of all health appointments, the outcomes of the appointments and any action that needs to be taken. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: Records of the receipt and administration of medication were seen. All records seen were complete and accurately recorded. Prescribed medicines are delivered monthly and are blister packed. We saw training records that show that all support staff undertake training in the administration of medication. Temperature checks are made and recorded daily for the fridge where medication is stored. We saw that guidance is in place for staff on checking blood sugar levels for a resident who has diabetes. The guidance includes what action needs to be taken if levels are either too high or too low. Training has been provided to staff by a diabetes nurse regarding how to do this. There is also clear guidance for the use of PRN, (as required), medication for each individual resident. This includes suggestions on what to do to try to avoid giving PRN medication. For example, for a resident who has problem sleeping the guidance says to try calming the resident, offer a warm drink, and encourage to relax and listen to quiet music. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has procedures in place for Safeguarding Vulnerable Adults and complaints. These procedures are followed when needed. Evidence: The home has a complaints policy and procedure, which is available in pictorial format. Residents told us that they know how to make a complaint if they need to. No complaints have been received in the last year. The homes procedures on Abuse, Adult Protection and Whistle Blowing were seen. They were detailed and included descriptions on different types of abuse. Staff files contained certificates that show that all staff have attended Adult Protection training. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a good standard of accommodation that is well maintained. Evidence: The Dell is a well presented home with good quality furniture and fittings. On the day of the visit it was clean and tidy. Since the last inspection the whole house has been redecorated and refurbished. Residents told us that they helped to choose the colours for their bedrooms and the communal areas of the home. A requirement was made at the last inspection that the home needed a planned maintenance and renewal programme for the fabric and decoration of the premises, with records kept. This requirement has now been met. The lounge and kitchen are very homely. The lounge is furnished with sofas and chairs and has modern entertainment equipment for the residents to use. The kitchen is a good size and has a large table that residents and staff can sit round together to eat their meals. There is a separate room for laundry facilities. Residents rooms are a good size and have en suite facilities. Each room has been personally individualised with family photos and personal belongings. One resident told Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: us that he loves England and has decorated his room with English flags. The home has a reasonable sized garden that is accessible for residents. There is a patio area with seating for people to use when the weather is nice. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive support from well trained and supported staff. There are enough staff to meet the needs of the residents. Evidence: There are two support staff plus the manager on duty all day and one waking and one sleeping night staff. Both staff we spoke with said that they felt there are enough staff to meet the needs of the current residents. We looked at the files of the most recently recruited staff. They contained all the required information and documents including Criminal Records Bureau and Protection Of Vulnerable Adults checks, two written references and application forms. We saw records that showed that staff receive monthly supervision sessions. This was confirmed by the staff we spoke with. Staff told us that their induction covered everything they needed to know about their job when they started. During the visit we witnessed the staff chatting and working with the residents in a friendly manner. The staff that we spoke with during the visit were very clear about the needs, likes, dislikes and preferred routines of the residents. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: The home has a staff training programme in place. The training programme includes courses in Food Safety, Infection Control, Safeguarding, Manual Handling, Fire Awareness, Health and Safety, First Aid, Challenging Behaviour, Epilepsy, Diabetes and Autism. Staff told us that they receive enough training to understand and meet the needs of the residents. Half of the staff team have a National Vocational Qualification in Care at level two or above. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a competent and experienced manager. The health and welfare of the residents and staff are protected. Evidence: At the last inspection a requirement was made that the home needed a registered manager in post. Mr Alex Callum registered with the Commission in November 2008. He is an experienced manager and has a Registered Managers Award and an NVQ Level Four in Care. This requirement has now been met. The home has produced a quality assurance system, which includes monthly Regulation 26 visits and questionnaires that are sent to care managers, residents and their families. Evesleigh Care Homes Ltd (ILIACE Group), who own the home collate and analyse the responses then feed back the results to the home for them to address any issues that have arisen. Safety certificates for equipment in the home were seen and found to be up to date. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: The Health and Safety Policies and Procedures were seen to be thorough. Staff have attended fire safety training. All of the staff hold a first aid certificate and the home records all accidents that occur. There is a policy for the prevention and management of infection and staff have received training in this subject. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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