Care Home: The Dolphins

Similar services:

• Hillview Farm
• Dalewood Respite Care
• Orchard,The
• REACH Upton Court Road
• Fairways
• Treloar College
• Kestrel House, St Anne`s Opportunity Centre,
• Pinta

What the care home does well People living in the home have their needs recognised and met by staff who understand them. Their health and personal care needs are considered by qualified people and the home provides the equipment and facilities they need. People are supported to give their views through the home`s one to one sessions. The home is comfortable and homely and is suitable for the people living there. What has improved since the last inspection? A registered manager has been appointed to manage the service. Communication has improved between the people living in the home and the staff working there, due to the better communication methods used such as Makaton signing and photographs. More activities are provided to suit the individuals living in the home, so that their social lives are more interesting. Massage and physiotherapy is provided for individuals who need it. The people living in the home are able to communicate what their wishes are about meals and menu planning, and the staff team are trained in helping them to eat. The recruitment procedures have improved and recently more people have been recruited to work in the home. What the care home could do better: The staff team need to have training about infection control, so that the people living in the home are protected from the spread of infection. The manager has identified in the AQAA what needs to happen in order for the home to continue it`s improvements, including the need to continue to reduce the home`s reliance on agency staff. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Dolphins 32 Aylesbury Road Thame Oxfordshire OX9 3AW     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: Kate Harrison     Date: 2 7 0 2 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 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (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 23 Information about the care home Name of care home: Address: The Dolphins 32 Aylesbury Road Thame Oxfordshire OX9 3AW 01844212463 01844212463 haroon@caretech-uk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Caretech Community Services Ltd care home 6 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 6. 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 Dolphins is a large detached house with gardens situated in Thame, Oxfordshire. It is registered to provide 24 hr care and support for up to six people with a learning disability. It is run and managed by CareTech Community Services, an organisation with experience in supporting people with learning disabilities. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 23 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: This inspection was an unannounced Key inspection and was conducted by one inspector over 6 hours during one day. It was a thorough look at how well the home is doing, and took into account detailed information provided by the home through the Annual Quality Assurance Assessment (the AQAA) and any other information we received about the service since the last inspection. We asked the views of people living in the home through our survey, but their responses were not available at the time of this report. We saw documents and records about the care provided and discussed the running of the home with the deputy manager. We saw all areas of the home used by the people living there, we looked at how the home manages peoples medication, and we observed lunchtime in the dining room. We looked at how the home is meeting the standards set by the government, and in this report we make judgements about the standards of the service. The date of the last inspection of the home was 13th September 2007. Care Homes for Adults (18-65 years) Page 5 of 23 The weekly fees are GB pounds 1056.70. 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 –03000 616161. Care Homes for Adults (18-65 years) Page 7 of 23 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 8 of 23 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. The home has good procedures in place to make sure the needs of anyone admitted to the home can be met. Evidence: The five people living in the home came in 1994, so it was not possible to check the homes recent admission process. The home has a pre-admission assessment procedure, including several visits to the home for the prospective new person, to test out the suitability of the home to meet his/her needs. The homes information Welcome to The Dolphins has recently been updated and is in pictorial format. Care Homes for Adults (18-65 years) Page 9 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have their needs and choices recognised, recorded and met, by a staff team who are trained in how to communicate, and are supported to be as independent as possible. Evidence: We saw the individual care plans for three of the individuals, and noted that they were written in a personal way, and contained detailed information and pictures about how to support them as they wanted. The plans were reviewed and updated regularly. All the individuals have difficulty in making their views known and the staff team use their experience and skills to try to understand the wishes of each individual. The staff team encourages individuals to make choices and regularly uses pictures for the individuals to choose from. Weekly sessions are held between individuals and their key workers when issues about choice can be explored using sign language and pictures. All the homes staff have had training recently in how to communicate using Makaton signing. The risk assessments we saw were personalised and showed that the individuals were encouraged and supported to live as independently as possible. Care Homes for Adults (18-65 years) Page 10 of 23 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. People are able to live the life they choose and be involved in family and community life. Evidence: The home has made improvements to the range and frequency of activities arranged for the people living there. Each individual has a social diary showing how the details of their life and leisure plan are carried out. We saw that one individual goes to two planned weekly activities and two monthly activities, and another has a similiar planned routine. Another goes to four regular activities. The home organises other activities such as bowling, and has the support of an extra support worker for these activities, and provides activities in house regularly. A variety of communication methods are used including photographs and Makaton signing. The outings to activities means that the individuals can meet other people and develop relationships if they want to. The home encourages family relationships and welcomes families to Care Homes for Adults (18-65 years) Page 11 of 23 Evidence: the home, especially for the regular reviews. We saw how lunchtime is organised, and noted that the staff team show respect for the individuals by giving choice whenever possible, and by explaining what is about to happen when assisting individuals to eat. Menus are developed with the aid of a pictorial recipe book, and the home tries to make sure that individuals receive good nutritious food, including plenty fruit and vegetables. Care Homes for Adults (18-65 years) Page 12 of 23 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. People living in the home have their health and personal care needs met in the way they want. Evidence: All the individuals living in the home have Health Action Plans, and we saw the plans for two people. They documented all the health needs of the individuals, including planning meetings with groups of healthcare professionals, the outcomes and follow ups. They are in pictorial form and include all the information needed by the staff team, including for example, photographs of how to put equipment together, and dates of next appointments. We saw that the health action plans brought together all the health needs of the people living in the home, including physical, emotional and psychological. We noted that staff had all the information they needed about how to provide personal care, in the way the individuals preferred. We discussed how the home could improve the nutritional assessments by using the evidence based Malnutrition Universal Screening Tool (MUST), and the deputy manager said this would be investigated. We checked how medication is managed in the home, and all medication is recorded on arrival, when administered and if needed to be returned to the pharmacy. Only Care Homes for Adults (18-65 years) Page 13 of 23 Evidence: staff members trained to do so can administer medication. A monitoring visit was carried out by the community pharmacist recently, and although there is no controlled drugs cupboard in the home the pharmacist is aware of this and is advising the home about how to respond if a need of controlled drugs is anticipitated. Care Homes for Adults (18-65 years) Page 14 of 23 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. People living in the home can rely on the staff team to understand when they are not happy or are suffering from harm, and do something to help them. Evidence: The homes complaints procedure is in pictorial format and it is used during one to one sessions with the individuals living in the home to discover any anxiety or unhappiness that can be addressed. The staff team are familiar with the individuals and together they try to interpret any behaviour out of the ordinary. All complaints are recorded and there have been no complaints made since our last inspection. We have received no information about complaints made to the home. The home has a safeguarding procedure to help staff members keep people living in the home safe. A safeguarding referral was made in November 2008 about the conduct of some agency staff in the home, and now all new agency staff attend an induction course at the home before starting work. Safeguarding training is provided for new staff. Care Homes for Adults (18-65 years) Page 15 of 23 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 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 comfortable and well maintained, although the agency staff need training about infection control. Evidence: We saw all communal areas of the home, and noted that they were clean and accessible. There are arrangements in place to address maintenance issues in the home and for the garden. We saw the laundry arrangements and noted that the facilities are appropriate to keep the home clean. Not all the agency staff have training about infection control, and from the records only one person from an agency working at the home has received recent training. Training about the prevention of infection must be provided for all staff working at the home, so that the staff group know what they need to do to keep the home free from inspection. Care Homes for Adults (18-65 years) Page 16 of 23 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. The people living in the home benefit from the homes understanding of their need for regular staff, and staff are safe and able to meet the needs of the individuals. Evidence: When we arrived there were three staff on duty, all agency staff, and there are usually two members of staff in the home at night, one awake and one sleeping. The deputy manager explained that the home has relied on agency staff for some time, and tries to make sure that the same staff are regularly supplied. The agency staff we saw at the home had worked regularly at the home and knew how to care for the needs of the people living there. Recently more permanent staff have been recruited and are awaiting to start work, and this will mean more stability for the people working at the home. We saw the recruitment files of three agency staff to check the recruitment procedures. The manager explained that she has started an arrangement with the agencies used by the home to supply identification including a photograph for new staff before they start work at the home, and this is good practice. We saw information from the agencies showing that they had sought and received clearance about the three individuals from the Criminal Records Bureau, and all the other necessary information. We saw that the home has a training programme, including induction for agency and Care Homes for Adults (18-65 years) Page 17 of 23 Evidence: permanent staff. The deputy manager is the homes trainer for some topics, and the training takes place at the home and at other venues. We saw the homes training matrix for permanent staff, and noted that a system is in place for training and updating permanent staff regularly, but agency staff have not received regular training about infection control. Care Homes for Adults (18-65 years) Page 18 of 23 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 improving and is increasingly run in the best interests of the people living there. Evidence: The home has a registered manager, as required at our last inspection visit, and she has the National Vocational Qualification (NVQ) Level 4 in Care and the Registered Managers Award. She and her team have worked hard to involve the people living in the home more in how their needs can be met, and this has led to the provision of more information, equipment and methods, to make communication easier. She has improved the way agency staff are recruited for the home, by having direct communication with agencies about the specific needs of the home. A quality review of the home takes place annually, and one was carried out in July 08 including questionaires to parents and representatives. Monthly unannounced visits are also carried out by a senior person in the organisation, to conduct a quality review of the home, including health and safety issues. The home has a fire risk assessment, and people living in the home have individual emergency evacuation plans. Training is provided for the permanent staff about health Care Homes for Adults (18-65 years) Page 19 of 23 Evidence: and safety issues in the home, and from the records seen all have attended or are booked to attend fire training, moving and handling training and food hygiene training. All also have first aid training. Care Homes for Adults (18-65 years) Page 20 of 23 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 21 of 23 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 1 30 13 Training about infection control must be provided for the people working in the home. So that people living in the home are protected from infection. 24/04/2009 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 22 of 23 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 23 of 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!