CARE HOMES FOR OLDER PEOPLE
Dalemain House 19 Westcliffe Road Southport Merseyside PR8 2BL Lead Inspector
Mrs Elaine Stoddart Key Unannounced Inspection 6th and13th December 2006 10:00 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 Dalemain House DS0000005320.V311116.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. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Dalemain House Address 19 Westcliffe Road Southport Merseyside PR8 2BL 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) 01704 568651 Mr Glen Alan McNair Mr Glen Alan McNair Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 24 OP Date of last inspection 5th January 2006 Brief Description of the Service: Dalemain House is a residential care home, which provides personal care and support for up to 24 older people. There were 20 residents accommodated at the time of the unannounced inspection. The home is owned and managed by Mr Glen McNair. The home is located in a residential area close to the town of Southport, which can be reached by the local transport services. The home is a large converted house and is decorated and furnished to a high standard. All areas are accessible by a passenger lift and there is ramped access to the front garden and small car park. Grab rails are available throughout. Call bell systems are in all rooms. Community facilities include a large comfortable lounge, dining room and a well maintained enclosed garden. Accommodation includes 11 single rooms, 9 with en suite and 5 en suite double rooms. Positive comments were received from residents and visiting relatives spoken with regarding the high standard of care and support provided. These comments are included within this report. The cost for the service is £355.50 per week. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The site visit took place over two days duration of nine hours. It was an unannounced visit and conducted as part of the regulatory requirement for care homes to be inspected at least twice a year. At the time of the visit twenty residents were accommodated. A tour of the building was conducted. A selection of staff files and home records were viewed. During the inspection three residents were case tracked (their care files were examined and their views of the home were obtained). This process was not carried out to the detriment of other residents who also took part in the inspection process. The site visit was conducted with the manager, Glen McNair and care manager, Nicky Walker-Houghton. Two care staff; the cook, seven residents, eight relatives and a district nurse were also spoken with to obtain their views of the home. During the second visit the home was celebrating their Christmas party and eighteen relatives were invited to attend to have their Christmas lunch with the residents. A very pleasant, relaxed and festive atmosphere was present and the relatives, residents and staff were observed to enjoy the festivities together. The home was decorated for Christmas both inside and out. Survey forms ‘Have your say about….’ were sent to residents/and or relatives to complete prior to the site visit. Comments received from the surveys and discussions, which took place, are incorporated within this inspection report. What the service does well:
Since the last inspection the home has met all the requirements and recommendations made. The home’s statement of purpose, service user guide and most recent inspection reports were displayed in the main hall for residents and/or their visitors to view. A copy of the statement of purpose and service user guide is also available in each resident’s room. The home has a pleasant relaxed atmosphere and at the time of both visits. All areas viewed were very clean and well maintained. During the second visit the residents, friends, family and staff were celebrating their Christmas party. The home had invited eighteen relatives and friends to have their lunch with the residents and two sittings for a four course Christmas dinner was provided for all. The home was decorated for the festive season both inside and out and a happy, friendly and festive atmosphere was present. All who attended commented on the pleasant surroundings, festive mood in place and the hard work of the staff involved in making it a special day. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 6 “The staff have put so much effort into this and the home looks lovely” (Relative). “I am having such a lovely time” (Resident). “It has been so nice to have lunch with my family” (Resident). The home makes visitors and relatives very welcome and relatives spoken with confirmed this. Comments include: “They always make us welcome. We call almost every day and are always offered drinks and snacks. The care here is brill”. “The care here is second to none” “The staff are like family” “They always make time to keep me up to date with Mum’s progress” “I never leave here and feel my Mum is not safe” The home provides comfortable areas for the residents to sit and chat to their visitors and relatives within the large comfortable lounge, pleasant dining room, private rooms and small landing area. The home employs a range of care, domestic, laundry, kitchen assistants and management to meet the needs of the residents and maintain the standard of the environment. Staff interviewed confirmed the management provides support and direction at all times. Comments include: “This is the best home I have worked in. The residents are cared for safely”. “The staff team are great” “I love it here” Staff were observed to interact positively with residents and relatives and a relaxed, friendly atmosphere was present during both visits. Records viewed are organised and easy to follow. Staff confirmed that they are provided with sufficient information to meet the needs of the residents. A key worker file is available in each residents room, which contains up to date information on their care needs, residents wishes, mobility procedures, risk assessment, medication and the homes policies on dignity and confidentiality. This information is regularly updated by the key worker and used by the manager when reviewing care plans. The manager / or care manager assess all prospective residents and a detailed plan of care is then written after admission. Specialist equipment is in place to meet the needs of the residents. The district nurses attend when required to meet the resident’s needs. All visits by health care professionals and personal hygiene routines i.e. baths, oral care, hair care are recorded. Visiting district nurses spoken to commented: “I am very happy with the care here. The staff are very responsive to the residents and record all care given”. To keep staff informed of the standards required by the Care Standards Act 2000 and what is involved in the regulatory inspection process. The manager has developed a ‘Care Standards File’. Each of the standards are identified and
Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 7 the documentation and information required to meet the standard. Staff are involved in the development of this and have access to it. The home seeks the views of residents/relatives and other visitors. A recent survey has taken place to seek the views of residents and relatives. Positive comments were received about the care and support provided. Resident and relatives meetings take place every three months. A monthly newsletter is produced, which keeps residents and relatives informed of developments and planned meetings and activities. A comment form for relatives to complete is available in all residents’ rooms should they wish to comment on their care. The home has an activity programme and support an attention is provided by care staff who sit with the residents helping with jigsaws and crafts. Other activities include a ‘music man’ entertainer, cheese and wine evenings, aromatherapy, reflexology and massage sessions. The residents were observed taking part in their Christmas party and are looking forward to a trip to the local pantomime in January 2007. A recent clothes party was organised and one visiting relative said, “It wasn’t just a clothes party it was an event as the staff put on a buffet with sherry after. It was lovely” Residents birthdays are celebrated and a relative spoken with said, “They really made a fuss. My mum certainly knew it was her birthday”. What has improved since the last inspection? What they could do better:
Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 8 No requirements were made. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 9 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 Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2,3. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are given sufficient information to enable them to make a choice whether to take up residency. Prospective residents are assessed to ensure the home can meet their needs. Each resident has a contract of terms and conditions. Standard 6, intermediate care is not provided. EVIDENCE: The home’s statement of purpose and service user guide was displayed in the main entrance hall along with copies of the most recent inspection reports for residents to view. The manager confirmed that this document has been updated recently therefore the information was accurate. Two of the three residents spoken with confirmed that they had received sufficient information prior to admission and were aware of the contents of the service user guide as each had a copy in their rooms. One resident was unable to remember the details and the comments are made below. The three residents have a contract of terms and conditions, which showed fees payable and additional charges.
Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 11 The residents have a choice to purchase a monthly package, which is payable on top of their weekly fees and includes hairdressing every two weeks, chiropody and manicure. Seven of the twenty residents accommodated are in receipt of this package. One resident, not on the package, confirmed that he receives a monthly account of his charges for papers, hairdressing and chiropody. The following comments were made: “I can’t remember if all the information was provided. I think so as they asked me a lot of questions about what I needed. My daughter deals with everything for me”. “Yes I got all the information on the home and came to have a look around” “I have seen my contract and know what my fees are” “I had a full assessment of my needs” “I had all the information prior to admission and have seen and signed my contract” Individual records are kept for each resident and the manager or care manager completes the assessment documentation prior to admission. As part of the case tracking process, three assessments were viewed. Residents who were case tracked stated that the staff had discussed various aspects of their care and social needs with them. The assessments contained details of the health, social and emotional care needs of each resident. The information obtained when residents complete the ‘journey of my life’ with their key worker contains past history, employment, hobbies, likes, dislikes and religious and cultural preferences. This information is then used to form the plan of care. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9,10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individual needs are outlined in detailed plans of care to ensure residents’ needs are fully met. Medication is administered safely and staff are trained. EVIDENCE: Residents have an individual care file and the information held is detailed, easy to read and organised. The resident’s plan of care is formulated from the initial assessment and this is followed up by a monthly review of dependency by the manager and key worker. Individual plans of care viewed demonstrated all care needs including personal, health, mobility, and weight and risk assessments. All health care visits are recorded, contacts with relatives and social activities participated in. Each resident has a copy of their plan of care and ‘journey of their life’ in their room and key workers have this information to enable them to carry out their roles. Each key worker has the responsibility of keeping this information up to date and informs the manager of any changing needs. A daily checklist is completed to ensure each resident has everything they need in the form of clean towels, toiletries and any repairs needed. Monthly checks are completed on the residents’ weight, health care
Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 13 reviews and should they require any new clothes. A copy of the home’s policies and procedures on dignity and confidentiality in kept in the key worker file for staff to access. The residents spoken with are aware that this information is available in their rooms and they confirmed their agreement with their plan of care. Three residents said they enjoyed completing their ‘journey of my life’ and speaking to the staff about their past experiences and family background. The staff were observed to interact positively with the residents, always took time to chat with them and knocked prior to entering their rooms. It was evident from direct observation that the residents and staff get on very well together. Residents spoken with confirmed that the staff treat them with dignity and respect at all times provided positive comments on their caring approach. “I couldn’t be anywhere better” “The staff are lovely they help me to bathe” “I like to have the privacy of my own room and the staff respect that” Relatives spoken with said: “The staff are very kind” “The staff are very caring and respect my Mother’s wishes to stay in her room. She chooses what she wants to do and what to take part in”. Staff interviewed showed a clear understanding of the needs of the residents and confirmed their involvement in reviewing their plans of care. Staff confirmed that they receive a verbal handover at each shift and are advised of any change in the resident’s condition or their care provision. Staff also record the daily care for both day and night shifts. Care files showed that access is available to dentist, optician, GP, chiropodist and district nursing services when required. This was confirmed through discussion with relatives, residents and visiting district nurses. District nurse records are kept at the home for staff to access. One district nurse spoken with said, “I am very happy with the care. The staff are very caring and responsive to the residents’ needs”. Two relatives who visit daily said, “The way they care for my Mother is excellent. She has been bedfast for two years and has never had a bed sore. Her records show us what she has eaten daily and how often she has been attended to”. Medicines are administered safely and staff have received formal training. A medication training up date was taking place on day of the inspection. MAR (medicine administration record) sheets were viewed and these evidenced staff signatures following administration. Medication policies and procedures are in place and all medication is securely stored. Those residents who wish to self administer their medication are risk assessed and records kept. A fridge is available for medication requiring storage at a certain temperature and temperatures recorded.
Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise choice regarding their daily life and the routine and social arrangements are based around their wishes and needs. EVIDENCE: The home encourages visitors to call and visitors were present during both visits. Two relatives were spoken with on the first visit and eighteen visitors attended the Christmas lunch during the second visit. All visitors were very complimentary regarding the care and support provided, the high standard of cleanliness and the pleasant approach of the staff. Visitors were observed to chat freely with staff, residents and other relatives. One visitor said “the relatives are now our friends as I see them often when I call in”. Other positive comments received from relatives include: “They always make us welcome. We call almost every day and are always offered drinks and snacks. The care here is brill”. “The care here is second to none” “The staff are like family” “They always make time to keep me up to date with Mum’s progress” “I never leave here and feel my Mum is not safe”
Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 15 Relatives spoken with confirmed they are made welcome at all times and the staff always have time to chat with them and keep them up to date with the residents progress. “The care manager Nicky is wonderful. The home is a credit to her. She always finds the time to have a chat with me”. Another relative said “ I was able to have lunch with my Mother and my my two sons, daughter and aunt were invited too. It was very special. Nothing is too much trouble for the home. They work very hard to please everyone”. The home has an activity programme and support an attention is provided by care staff who sit with the residents helping with jigsaws and crafts. Other activities include a ‘music man’ entertainer, cheese and wine evenings, aromatherapy, reflexology and massage sessions. A trip to the local pantomime is organised for January 2007. A recent clothes party was organised and one visiting relative said, “It wasn’t just a clothes party it was an event as the staff put on a buffet with sherry after. It was lovely” Residents birthdays are celebrated and a relative spoken with said, “They really made a fuss. My mum certainly knew it was her birthday”. Staff encourage residents to be as independent as their conditon allows and several residents go out most days for the purpose of shopping or visiting friends/family members. This was evidenced during the site visit. Residents who like to spend time in their rooms have their wishes repsected by staff. The home offers a good range of hot and cold meals and residents interviewed were complimentary regarding the foods prepared. Alternatives are available and snacks and drinks offered during the day. The residents have the choice of a cooked breakfast if they wish. The manager said, “They can have whatever they want”. Comments from residents include: “The meals are lovely” “Really good food” The Christmas lunch consisted of a four-course meal and twenty residents and eighteen visitors were catered for over two sittings. All were observed to enjoy the events of the day. New food analysis records are being introduced in accordance with guidance from environmental health. The manager had recorded fridge, freezer and hot food temperatures. The kitchen was organised and clean on inspection. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident that their complaints would be listened to and acted upon. The home has an abuse policy to help protect residents. EVIDENCE: A complaints policy and procedure is in place and the complaint log evidenced that no complaints have been received since the last inspection. Details of the complaint procedure can also be found in the service user guide and residents interviewed stated that they would report any worries or complaints to the manager. The home has introduced and ‘constructive suggestions ‘ form for the residents and relatives to complete regarding any comments. Staff interviewed described what action they would take should a resident have a worry or concern. Comments from residents included: “I haven’t found anything wrong” “I would speak to Nicky, care manager” Staff receive training regarding abuse awareness and the home has an abuse policy and a copy of Sefton and Liverpool’s Guide on Adult Protection. Financial policies and procedures are in place and all transactions are recorded. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,20,21,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers very comfortable ‘homely’ accommodation and all areas are well maintained. This contributes to a good quality of life for the residents. EVIDENCE: A tour of the premises confirmed that the home is maintained in a good condition with an ongoing programme of decoration and refurbishment. Since the last inspection a number of rooms have been decorated, new furniture purchased and new flooring in bathrooms. The home was found to be clean and odour free, residents confirmed that their rooms are tidied every day and clean towels provided. Key workers conduct a daily check to ensure the residents have everything they need and repairs are addressed. Day to day jobs are carried out by Mr McNair and outside contractors are brought in for extensive repairs and overall maintenance of equipment. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 18 The bathrooms are fitted with aids to assist less independent residents and handrails are fitted throughout. Bath temperatures are recorded to ensure the hot water was delivered to a safe temperature. The entrance hall provides a welcome approach to the home and information on the home and most recent inspection report is available here for any visitors to access. The activities and next resident/relative meetings are displayed on the notice board. Each resident has a ‘mail slot’ where his or her mail can be collected. As previously stated, the home has been decorated for Christmas both inside and outside. The lounge is spacious and has sufficient armchairs for the residents. The dining room is comfortable and dining room tables were attractively laid for the Christmas lunch. A small first landing area provides a comfortable setting for residents to sit or meet with their relatives. This area was also decorated with a Christmas tree and good quality furnishings. The home has a well-maintained front garden with a water feature and car parking at the side. Radiator covers are in place in most areas. Risk assessments are provided if covers are not in place to ensure residents are protected. Although Standard 22 (adaptations and equipment) was not assessed it was noted that a resident had been provided with a special bed following a care needs assessment. Residents have the use of a call bell with an alarm system. Bedrooms viewed had personal items and they were warm and pleasantly decorated. Residents interviewed were pleased with the standard of furnishings and described the rooms as “Spotless”, “Comfortable”, “Homely” and “Couldn’t be anywhere better”. Relatives spoken with said, “The home is a credit to Nicky it has improved so much”. “It is always spotless and the atmosphere lovely”. Emergency lighting is provided throughout the building and subject to a maintenance contract. Records seen were current. The home was found to be clean and hygienic. Plenty of protective clothing was available. There was good evidence of cross infection control measures in place. The home has a small laundry with sufficient equipment and residents stated that items of clothing were returned promptly. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment and selection procedures are robust and staff receive training to equip them with the skills to do their jobs. This helps safeguard and protect the people living in the home. EVIDENCE: On the day of the site visit, the manager and care manager were on duty with three care staff and one cook. The home employs senior care staff to support the manager. The staffing rota was viewed for the week of the site visit and confirmed the staff on duty. This evidenced sufficient number of staff employed. Three Through direct observation it was evident that staff provide a good standard of care. The home has an ongoing training programme to ensure the staff have the knowledge and skills to meet the needs of the residents. A training matrix is in place and staff attend courses in moving and handling staff records were viewed and these evidenced completed job application forms and referees had been contacted for two references prior to commencing work at the home. CRBs (Criminal record bureau disclosures) and POVA (Protection of Vulnerable Adult) checks were in place. Residents and relatives interviewed were complimentary regarding the standard of care they receive, comments included:
Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 20 “They are very kind” (Resident). “The staff are very caring” (Relative). “I couldn’t be anywhere better” (Resident). “The staff always have time for a chat” (Relative). “My Mother is content and happy and I can’t thank the staff enough for helping this happen” (Relative)., fire safety, first aid, food hygiene, health and safety, abuse awareness and infection control. Medication and fire training was being provided on the day of the visit. Staff files viewed were very organised and contained all the information required. Induction records were seen for new staff and a staff member stated that she was provided with this by the care manager when she started. All staff are encouraged to undertake NVQ studies and the home has achieved over 50 with a qualifcation at Level 2 and/or Level 3. All staff employed receive a code of practice and sign the policies and procedures when read and understood. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,32,33,35,36,38. Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents live in a home that is very well managed and is run in their best interests. EVIDENCE: The Manager, Mr McNair, has many years experience in the care of older people and is supported by Nicky Walker-Houghton, care manager and senior care staff. Both are taking NVQ management qualifications and hope to complete in early 2007. It was evident through discussion with staff, residents and relatives that Mr McNair and Nicky Walker-Houghton have the best interests of the residents at heart. Both are committed to providing a high standard of care and a homely environment for the residents to live. Staff members said, “Glen and Nicky are always available and give support”, “It’s the best place that I have worked in and I have worked in care homes for ten years”, “We have a good team of staff”. A staff supervision and appraisal
Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 22 system is now in place and staff interviewed said they get ‘lots of support’. A staff bonus scheme has been introduced and staff are rewarded quarterly on their loyalty, training achievements and time keeping. Staff, resident and relatives meetings are arranged and recorded to involve them in the day to day running of the home. Regualr surveys are conducted and a recent survey resulted in 94 satisfaction achieved. Residents provided positive comments on the management of the home. “Nicky is wonderful and the home is a credit to her”. Some of the residents do not have the capacity to manage their own finances, or choose not to. The policy of the home is for relatives to manage this. The manager manages personal allowances in house with input from relatives where needed. The home employs a financial advisor who manages finances and residents bills. A number of records were viewed and these were maintained to a satisfactory standard. Policies and procedures are rveviewed annually to ensure they are in line with current legislation and to ensure best practice. This was evidenced via the pre inspection questionnaire. The fire log book was inspected and this evidenced the weekly fire alarm tests and monthly test of emergency lighting. Fire awareness training is provided for staff. During the visit a fire risk assessment was taking place and training on fire awareness delivered to staff by Fire Reliant. Fire drills do not take place and the manager is to consult with the fire authority on this. All accidents and injuries are recorded. The home monitors these closely and and takes action to eliminate risks were possible should residents be prone to falls. The pre inspection questionnaire evidenced that the home has a full range of maintenance contracts and checks for equipment and safe working practices. This includes gas, electric, lift, portable appliances and emegency call systems. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 23 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 4 4 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 3 X 3 Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP38 Good Practice Recommendations The manager should consult with the Fire Service to obtain information on conducting fire drills. Dalemain House DS0000005320.V311116.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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