CARE HOMES FOR OLDER PEOPLE
Da-Mar Residential Care Home Da-Mar Residential Care Home 83-87 Moore Street Northampton NN2 7HU Lead Inspector
Mrs Helen Wilson Unannounced Inspection 17th August 2006 11:30 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 Da-Mar Residential Care Home DS0000067519.V307234.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 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. Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Da-Mar Residential Care Home Address Da-Mar Residential Care Home 83-87 Moore Street Northampton NN2 7HU 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) 01604 791705 01604 715850 Mr Anthony L Lampitt Mr Anthony L Lampitt Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29), Physical disability over 65 years of age (7) of places Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Any service user allocated the top floor front single bedroom, previously the staff training room, must have assessed identified care needs of full independent mobility. No one falling within category PD (E) may be admitted into the home where there are seven persons of category PD (E) already accommodated within the home. The total number of service users must not exceed twenty nine. Date of last inspection Not applicable Brief Description of the Service: Da-Mar is a privately owned care home providing care for up to a total of 29 service users within the category of old age. Within this total of 29 the home is registered to provide care for up to 7 persons with a physical disability. Nursing Care is not provided at this home. Da-Mar is located in a residential area close to the town centre of Northampton and near to local shops. The building has been extended twice and offers communal accommodation, bedrooms and bathrooms over three floors. The home does not have a passenger lift. There is a stair lift from ground floor to second floor in the old part of the house, but only a staircase from the second to the top floor. People with a physical disability are accommodated in the newer rear part of the home where a stair lift is available from ground floor to first floor. Service users have access to a secluded garden and car parking spaces can be found to the side of the home. The current range of fees is from £331.00 to £360.00 approx with the home accepting both private and funded placements. In addition extra charges are made for hairdressing and chiropody services and newspapers. Any charges incurred for private dentistry or ophthalmic services are the responsibility of the service users. Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is on outcomes for residents and their views of the service provided. Da-Mar, an existing residential care home, was bought over by Mr Lampitt in May 2006 and the home’s staff team remained in place providing continuity of care for the service users. This inspection is the first to take place since the home’s change in ownership and was carried out on an unannounced basis with the deputy manager present and lasted approx six hours. Inspection planning took one half day and consisted of a full review of the home’s service history record including notifications of accidents, events and incidents and any comments received from service users and relatives. The information was collated and analysed to form the plan of inspection focusing on the outcomes for service users. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they receive through review of their records, talking with them and the care staff. A partial tour of the premises took place, a selection of records was inspected and discussions were held with the deputy manager, some staff and three service users. It was clear from this inspection that the environment of the home has improved and work is ongoing. Significant progress has been made in drawing together detailed care plans to guide staff on working with service users. What the service does well:
The owner has begun a programme of redecoration and refurbishment of the home. Service users are being sensitively moved temporarily to alternative bedrooms while the decoration programme takes place. New beds have been bought for all bedrooms and bedrooms are being in turn wallpapered and carpeted with current service users choosing colours from a range of samples. One new bedroom on the front second floor is being fitted with an en-suite toilet area with wash hand basin. Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 6 Service users said that their new beds were really comfortable and that the new bedding was fresh and much improved. The standard of the laundry and housekeeping is being maintained at a good level. The care staff team have good rapport with the service users. Observations confirmed that staff ensure that service users are given personal care in a dignified manner and in private. Service users said that staff are always available to them, that call bells are answered in good time, that staff both male and female are pleasant and they feel at ease with each carer. The deputy manager has reviewed care plans and risk assessments with all service users to set up working plans and agreed ways for staff to provide care to meet the needs of individuals living at Da-Mar. The care plans are detailed and specify to staff how the personal care is to be offered to each individual service user. This is excellent progress in giving guidance to staff and gives consistency of care to service users. The system for ordering and administering of medication supplies required by service users is good. The weekly menu plans showed a variety of British/Indian/Mediterranean meals provided. The main cook is employed each weekday and prepares meals, puddings and cakes from fresh/frozen and dry ingredients. Service users have a choice of two main courses for lunch and choices at teatime of various sandwiches and cake. Service users said the cook was fully aware of their dietary needs and likes and dislikes. The serving of the midday meal was efficient and service users were given help by staff where necessary to eat their meals. Three staff members’ files inspected showed that the necessary clearances and references had been obtained prior to staff commencing work to ensure the protection of service users. What has improved since the last inspection?
Work has started to alter an unsuitable ground floor double bedroom into a main office for the home where visitors can meet with managers. Washable hard flooring had been installed in past months by the previous owner in the rear corridor and rear dining room and many bedrooms had hardflooring rather than carpets to aid housekeeping; it was refreshing to hear from the new owner that there would be no further areas of the home’s floors given this type of covering. From this inspection it could be seen that already action has been taken to provide carpets in certain bedrooms.
Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 7 The existing stairlift in the front main house has had to be replaced as it was inoperable. Service users said how pleased they were with the new model that removes an unsightly and insecure platform and said they felt safer now the platform is no longer required. 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. Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 8 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 Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 9 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): 1,3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear information available about its services and admission processes that give prospective service users informed choice about whether Da-Mar is suitable for their needs. EVIDENCE: The home has a set of informative documents that shows prospective service users and families what Da-Mar offers. These documents are kept under review. The admission process ensures that all prospective service users are visited and assessed by the home. Service users and their relatives have opportunities to visit the home to in order that they can discuss their needs further and are enabled to make an informed decision on the placement. The home does not offer short-term services to people regaining skills for independent living.
Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 10 Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 11 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): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by the home as their care needs and risks are assessed in detail and care provided to meet these individual needs. EVIDENCE: The deputy manager has reviewed care plans and risk assessments with all service users to set up working plans and agreed ways for staff to provide care to meet the needs of individuals living at Da-Mar. The care plans are detailed and specify to staff how the personal care is to be offered to each individual service user. This is excellent progress in giving guidance to staff and gives consistency of care to service users. Observations confirmed that staff ensured the protection of service users’ dignity and privacy by carrying out personal care tasks in private. Service users spoke positively about staff taking care to put them at their ease when personal care tasks were carried out.
Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 12 Service users are registered with local GPs and have access when necessary to dentists, opticians and chiropodists. District nurses visit the home to attend to specific service users who need elements of community nursing care. The system for ordering and administering of medication supplies required by service users is good. During medication rounds there is a problem in that at certain points in the home the medication trolley cannot be taken upstairs and this results in an additional staff member needing to stand guard over the medication whilst the other staff member takes the required medication up to the individual service users. The owner may wish to consider how this practice can be better managed. Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 13 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): 12,13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to lead ordinary lives and have choice in what activities to attend. EVIDENCE: Each person said that they were well treated by the care staff and were comfortable with staff during personal care being carried out. There were photographs displayed showing the service users enjoying a recent barbeque in the courtyard with staff and families attending. Two service users said that staff had begun to ask about new activities that people would like to have organised. Two service users said they preferred to remain in their own rooms during the day choosing to eat there and watch television and also choose not join in the activities such as weekly bingo sessions that take place in the rear lounge area. Other service users said they regularly joined in the bingo. One service user proudly showed the inspector the prize he had been given.
Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 14 Although service users’ casefiles identified religious affiliations, no service users said that they either went out to chosen services or had home visits from their religious leaders. The home provides service users with a balanced diet. The weekly menu plans showed a variety of British/Indian/Mediterranean meals provided. The main cook is employed each weekday and prepares meals, puddings and cakes from fresh/frozen and dry ingredients. Service users have a choice of two main courses for lunch and choices at teatime of various sandwiches and cake. Service users said the cook was fully aware of their dietary needs and likes and dislikes. The serving of the midday meal was efficient and service users were given help by staff where necessary to eat their meals. Service users’ comments on the food provision were mixed; some people were of the view that the standard of food and how well it is cooked and presented is dependent on whether is a weekday or a weekend; other people said that the food was tasty and well-cooked and to their liking. Visitors were seen being warmly welcomed into the home by staff. One service user said that her private hairdresser visits each week. Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 15 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): 16,17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Responses to complaints have been appropriate and service users’ protection safeguarded. EVIDENCE: The home has a well-publicised procedure for handling complaints and receiving compliments. The owner had received several complaints in recent months from one source regarding bedroom accommodation, staff response time to call bells and regarding the interaction of one other service user. These issues were investigated by the home and also with other relevant agencies and matters resolved. Policies and staff procedures for the Protection of Vulnerable Adults are in place at Da Mar and several staff have recently undertaken training on how to recognise and report concerns or suspicions. Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 16 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): 19,20,21,22,23,24,25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owner has begun to significantly improve the physical environment for service users. Safety improvements are however required in the long ground floor corridor. EVIDENCE: The owner has begun a programme of redecoration and refurbishment of the home. Service users are being sensitively moved temporarily to other alternative bedrooms while the decoration programme takes place. New beds have been bought for all bedrooms and bedrooms are being in turn wallpapered and carpeted with current service users choosing colours from a range of samples. One new bedroom on the front second floor is being fitted with an en-suite toilet area with wash hand basin. Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 17 Service users said that their new beds were really comfortable and that the new bedding was fresh and much improved. Bedrooms have been in most cases been personalised by the addition of photographs and small ornaments. Work has started to alter an unsuitable ground floor double bedroom into a main office for the home where visitors can meet with managers. The owner has rearranged the dining room to the front of the ground floor and the main lounge is now sited in the rear part of the building. One service user who has a one-side disability was observed having difficulty in negotiating along the long corridor safely from the dining room to the rear part of the building. Supervision of vulnerable service users must be increased in this long corridor until risks to service users’ safety are minimised. The deputy manager was asked to ensure that staff assist service users, that a handrail is installed on each wall in this corridor and that furniture is removed that was lining and blocking movement along this corridor to reduce the risks of falls. The standard of the laundry and housekeeping is being maintained at a good level. The home has discontinued use of a rear ground floor shower room since it was in practice too small for use with service users who use wheelchairs or needed staff assistance. Discussion in May 2006 with the new owner identified the possibility of combining the redundant shower room with an adjoining toilet to provide a usable facility. Thermostatic valves have been fitted to bedroom taps and bath outlets to protect service users from risks of hot water. The home has a stairlift fitted to one staircase between the ground and middle floors of the front main house but no stairlift on the staircase from the middle to the top of the house. Service users who have mobility problems are therefore unable to have access to the front upper floor bedroom areas. The Commission for Social Care Inspection awaits further discussion with the owner regarding future development plans for the home that could include a passenger lift to upper floors. Meantime the existing stairlift has had to be replaced as it was inoperable. Service users said how pleased they were with the new model that removes an unsightly and insecure platform. Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 18 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): 27,28,29 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 has been able to demonstrate robust recruitment and has put a training programme in place so that staff will obtain qualifications and skills. EVIDENCE: The care staff team have good rapport with the service users. The inspector noted that staff ensure that people are given personal care in a dignified manner and in private. Service users said that staff are always available to them, that call bells are answered in good time, that staff both male and female are pleasant and they feel at ease with each carer. Three staff files were checked and were found to contain all required details including identification, CRB checks, appropriate references and copies of relevant training qualifications. Records of supervision show that staff are given formal supervision at regular intervals. No issues of a disciplinary nature were shown. Three staff confirmed that they had successfully completed their National Vocational Qualification Level 3 in care. Training records were available for all staff and showed that only a father two staff members hold National Vocational Qualification Level 2 and this does not meet the required standard expectation
Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 19 that 50 of staff be qualified in care. The basic training programme drawn up in August 2006 identifies the need for further staff qualification. Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 20 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): 31,32,33,35,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Management systems are robust covering health and safety working practices. Interaction of managers with service users has improved. EVIDENCE: The owner is also the Registered Manager of Da-Mar and has stated he dedicates full-time hours at the home. The deputy manager who is currently undertaking a Registered Manager’s Award training course assists him. A part-time administrator has joined the staff team. The owner has also introduced new suppliers and maintenance contracts to the home. The owner has not yet introduced a system for reviewing quality assurance and quality monitoring of the home’s practices and services. Comments made by service users to the inspector were however positive about the physical environment changes that have been carried out. Two service users remarked
Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 21 that they often see the managers walking about and having time to talk to people. The home does not handle the personal monies of service users. Staff files identified that formal supervision sessions take place regularly. Regular tests are carried out in relation to electrical wiring, electrical appliances, fire protection equipment and systems, hoists, water supply, gas safety and the stairlifts. All are satisfactory. The Registered Person now operates Da-Mar Residential Care home under the trading name of a limited company, Care Northampton Ltd. Discussions were held with the owner Mr Lampitt in May 2006 about the need for him to apply for registration as a limited company to run the home; during this inspection application forms were left on the premises for completion and return by 30 September 2006 for this purpose. Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 22 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 2 1 3 2 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 X 3 Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 OP22 Regulation 12(1) 13(4,5,6) Requirement The Registered Person must increase staff supervision of vulnerable service users in the long corridor between the rear lounge and the front main dining room and minimise risks to service users’ safety. The Registered Person must ensure the safety of service users by installing a handrail along each wall of the long corridor between the rear lounge and the front main dining room. Furniture, that was lining and blocking movement along the long corridor between the rear lounge and the front main dining room, must be removed to reduce the risks of falls. Timescale for action 31/08/06 2 OP22 12(1) 13(4,5,6) 30/09/06 3 OP22 12(1) 13(4,5,6) 30/09/06 Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP33 Good Practice Recommendations The Registered Person should introduce a system for reviewing quality assurance and quality monitoring of the home’s practices and services that involves the views of service users and other relevant parties. Further consideration should be given as soon as practicable to combining the redundant ground floor rear shower room with an adjoining toilet to provide a usable facility. 2 OP21 Da-Mar Residential Care Home DS0000067519.V307234.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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