Inspection on 28/02/06 for 99 -105 Durham Care Homes

This inspection was carried out on 28th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

99 -105 Durham Care Homes 03/01/08

99 -105 Durham Care Homes 23/11/06

99 -105 Durham Care Homes 03/11/05

99 -105 Durham Care Homes 16/02/05

99 -105 Durham Care Homes 21/10/04

Similar services:

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE 99 -105 Durham Care Homes 99-105 Durham Street Holderness Road Hull East Yorkshire HU8 8RF Lead Inspector Eileen Engelmann Unannounced Inspection 28th February 2006 11:15 X10015.doc Version 1.40 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 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 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 Older People. 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. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 99 -105 Durham Care Homes Address 99-105 Durham Street Holderness Road Hull East Yorkshire HU8 8RF 01482 229766 01482 229766 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) Durham Care Homes Mrs Joan Langfield Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: Durham Care Homes is situated to the east of the city of Hull, on Durham street, which runs off a main road. The home is registered to provide care and accommodation for twenty older people who may also be suffering from dementia. There are fourteen single rooms and three shared rooms. A large lounge and a dining room are available on the ground floor of the home, and a small lounge is available on the first floor. A small car park and patio/garden area is available to the rear of the premises for residents use. Shops, churches and local health facilities are all accessible within a small distance, public transport is also available close to the home on the main road. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out with the deputy manager; staff and residents of Country Court care home. The inspection took 2.75 hours and included a tour of the premises, examination of staff and resident files and records relating to the service. Some of the residents were spoken with, as well as chats with staff members as they worked. All the key standards have been inspected in the past year and information on these and their outcomes can be found in the report for 3rd November 2005 and this one. What the service does well: What has improved since the last inspection? What they could do better: Medication giving practices must get better to make sure that no errors or mistakes are made, which could affect the health of the residents. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 6 The management of the home may wish to consider making changes to the ground floor bathroom to make it easier for residents to use. 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. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. All residents undergo a full needs assessment and are given sufficient information about the home and its facilities prior to admission, to enable them to be confident that their needs can be met by the service. EVIDENCE: The home continues to meet the criteria of standard 3. All residents at the home have their own personal file and the three looked at were for fairly new residents. Each individual had a need assessment completed by the funding authority and the home has also completed its own needs assessment before a placement was offered to the resident. Two residents spoken to were able to give detailed information about their care needs and the input they required from the staff, service and outside professionals, and this was found to be accurately documented within their care plans. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 and 10. The health, personal and social care needs of the residents are clearly documented and are being met by the service and staff. Improvements are needed to the medication practices to ensure the residents are kept safe from harm. EVIDENCE: The home continues to produce and keep clear and accurate care plans for the residents. Individual care plans are in place for all residents and set out the health, personal and social care needs identified for each person. Risk assessments are carried out for all individuals and three of the plans looked at have been evaluated on a monthly basis. Any changes to the care being given is documented and implemented by the staff. Daily care notes written by the staff are brief and do not always fully detail the care being given. Discussion with the deputy manager and observation of the staff at work indicated that the staff are very knowledgeable about the care needs of the individual residents, but this is not always written down into the care plan. The deputy manager said she would address these issues through staff supervision. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 10 The home has made some changes to the medication system since the last inspection, in response to the recommendations of the report. A running total of each medication held in the home is documented onto the current MAR chart for the individual residents, to ensure auditing of stock is easier for staff to do. Checks of the records and the medication trolley showed that signatures and stock are up to date and balance, however observation of the staff practice of giving medications out caused some concern. The member of staff observed was seen to dispense the medications to the residents in the dining room and leave the signing of those given to the end of the drugs round. This practice is not safe and could lead to errors or mistakes being made. The individual knew exactly what she had done wrong when questioned about this by the inspector and said that she would remember in future to sign when she had given each resident their medication. The manager should do spot checks to ensure staff are following the policies and procedures accurately. Two residents and their visiting relatives spoke to the inspector about the home. Both residents were fairly new into the home and said that the staff had been extremely helpful in assisting them to settle into their rooms and feel at ease. Feedback about the service and care giving was very positive and the individuals commented that ‘the home is lovely’ and ‘the staff are so friendly’. The two residents said that staff respected their privacy and dignity throughout the care giving process and that they were able to express their wishes about daily living practices and staff made sure these were carried out. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14. The home promotes the residents right to exercise choice and control over their lives and offers information and contact details so they or their families can contact external agents, who will act in their interests. EVIDENCE: Two residents spoken to were well aware of their rights and said that they had family members who acted on their behalf and took care of their finances. The deputy manager said she is aware of the advocacy groups in the community that residents can access, and the contact information is on display within the home and recorded in the residents care plans. All the residents said that the home encouraged them to bring in small items of furniture and personal possessions to decorate their bedrooms. Discussion with the residents showed that they were aware of their care plans and were able to input to them and access them through their key workers. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. The home has a complaints procedure, which meets the needs of residents, and relatives who feel their views are listened to. EVIDENCE: A comprehensive complaints procedure is available and records of complaints are held. Two residents showed a clear understanding about how to make their views and opinions heard and said ‘the manager comes round to see us regularly and talks to us about any niggles we may have. She tries to solve them immediately and will get back to us if she needs to take time to resolve them’. The complaints records show that the manager has received three minor complaints since the last inspection, and these have been investigated and resolved. At the moment complaints are recorded in a bound book, but this does not offer individuals confidentiality because the format means that anyone writing in the book can see previous complaints that have been made by different people. The inspector recommended that a separate complaints form should be developed that can be filled in by the complainant or staff and filed away by the manager once an issue has been investigated and resolved. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 and 26. The standard of the environment within this home is satisfactory, providing residents with a comfortable and homely place to live. EVIDENCE: The home has an ongoing programme of routine maintenance and decoration that ensures the environment is kept safe, clean and well presented. Since the last inspection the home has provided new armchairs in the lounge and residents spoken to said ‘these are very comfortable to sit in’. All areas seen by the inspector were clean, bright and well decorated, no malodours were noted. The home has a small laundry within the premises, which handles all the linen and clothing from the residents. Feedback from the residents was positive about this service, and individuals spoken to said ‘the staff take good care of our clothes and bring them back quickly’. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 14 Discussion with the deputy manager indicated that there have been no changes to the bathrooms within the home, despite the recommendation for adaptation of the unassisted facilities in the last report. ‘‘A bath hoist is available which had been serviced as required. There are two bathrooms, which do not have hoists or chairs available. The manager explained that discussions were been held in regard to the re equipping of the ground floor bathroom.’’ 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27. Sufficient staff are employed to ensure there is a good match of well-qualified staff offering consistency of care within the home. EVIDENCE: The home continues to employ sufficient staff to meet the needs of the residents. The home has twenty residents in at the moment and the staffing rotas show that on average there are one senior carer and two care assistants (plus the manager and deputy) from 7.30 am to 2.30pm, one senior carer and two care assistants from 2.30pm to 10.00pm (with an additional person from 3.30pm to 7.30pm) and one senior carer and one care assistant at night. Residents and relatives spoken to are very happy with the amount of staff on duty and said ‘they are always quick to answer the call bell and give you assistance when you need it’. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 35. The management of the home is satisfactory overall, and satisfactory accounting and financial systems are in place to protect and safeguard the interests of the residents. EVIDENCE: No changes to standard 31 have taken place since the last inspection. ‘’ The manager of the home has lengthy experience of residential care and has been the manager at the home for around nine years. The manager holds an NVQ 4 in management and is undertaking an NVQ 4 in care. She should ensure that this is completed as soon as practical. The manager is registered with the Commission for Social Care Inspection.’’ Checks of the financial records for resident’s personal allowances showed that money comes to the home from Country Court (sister home) each week, and this is allocated to each resident and kept safe within the home. Any monies which are held on residents behalf are recorded and held individually, receipts 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 17 are obtained for any spending, such as on hairdressing or the tuck shop. If an individual’s personal allowance gets above the amount that is mentioned in the homes insurance limit, then the surplus is either given back to the resident or their family (if applicable) or put into a non-interest bearing communal resident account. The inspector recommended that information about the noninterest bearing account is put into the service user guide so resident’s can decide if they wish to put their money elsewhere. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X 2 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 X X X 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 Requirement Medicines in the custody of the home must be handled according to the requirements of the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society, and the requirements of the Misuse of Drugs Act 1971. Timescale for action 08/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP16 Good Practice Recommendations The manager should do spot checks to ensure staff are following the policies and procedures accurately. The manager should develop a separate complaints form that can be filled in by the complainant or staff and filed away by the manager once an issue has been investigated and resolved. The registered provider should give consideration to adapting the unassisted bathrooms to make them more useable by residents. The Registered manager should obtain an NVQ level 4 DS0000000845.V280108.R01.S.doc Version 5.1 Page 20 3 4. OP21 OP31 99 -105 Durham Care Homes qualification in care. 5 OP35 Information about the non-interest bearing account should be put into the service user guide so resident’s can decide if they wish to place their money elsewhere. 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 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 99 -105 Durham Care Homes DS0000000845.V280108.R01.S.doc Version 5.1 Page 22 - 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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