Inspection on 22/12/06 for Dalkeith Lodge

This inspection was carried out on 22nd December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dalkeith Lodge 27/11/07

Dalkeith Lodge 03/03/06

Dalkeith Lodge 18/01/05

Dalkeith Lodge 18/05/04

Dalkeith Lodge 21/02/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Dalkeith Lodge 41 Mickleburgh Hill Herne Bay Kent CT6 6DT Lead Inspector Mark Hemmings Key Unannounced Inspection 22nd December 2006 09:15 Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 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 Dalkeith Lodge DS0000023389.V299958.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 Adults 18-65. 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. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dalkeith Lodge Address 41 Mickleburgh Hill Herne Bay Kent CT6 6DT 01227 362820 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) sheorattan@aol.com Mrs Baswantee Sheo-Rattan Mrs Baswantee Shep-Rattan Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One Service User whose date of birth is 14/09/1933. Date of last inspection 3rd March 2006 Brief Description of the Service: Dalkeith Lodge (the Service) is registered to provide accommodation and personal care for eight people (service users) who have a learning disability. The accommodation is arranged on three floors. When full, there is provision for two of the bedrooms to be shared by two service users each. All of the remaining bedrooms are for single occupancy. All of the bedrooms have a private wash hand basin. The property is detached and is located in a residential street. It is within normal walking distance of Herne Bay town centre. There is some private off-road car parking. There is an attractive garden to the rear of the property. People who are interested in finding out about the Service, can read the Service Users’ Guide and the Statement of Purpose. These are available from the Registered Provider. Between them, they give a lot of information about the facilities and services which are provided in the Service. The weekly fee for residence in Dalkeith Lodge is £323.03. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Report is based upon a number of sources of evidence. These include a review of the correspondence about the Service, which has been received by the Commission since the last inspection visit. Another source of evidence, involves written information received from service users, from their relatives and from care managers (social workers). Also, the Inspector completed an unannounced site visit to the Home. This took about five hours to complete. During this time, the Inspector spoke with three of the seven service users in residence. Some of these discussions were in private. The Inspector spoke with the Registered Provider and with one of the support workers. Also, he spoke with two of the service users’ relatives. The Inspector examined various parts of the accommodation and he reviewed a selection of the key records and documents. In general, the Registered Provider operates the Home so as to provide the service users with the support they need to enable them to lead normal lives of their own choosing. There are three Required Developments at the end of this Report. What the service does well: Service users say that the Service provides them with a relaxed and comfortable setting within which to make their home. They say that they receive all the assistance they need. Also, they consider that the support workers are attentive and kind in their manner. The service users are assisted to receive promptly any medical attention which might be needed. Also, they are provided with adequate and varied meals. There are arrangements in place to ensure that support workers know what they are doing. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. There are systems in place to ensure that prospective service users have their needs assessed. EVIDENCE: In the absence of any new admissions since the last inspection visit, the Inspector was not able to examine how in practice the Registered Provider ensures that the Home is a suitable place for everyone who is admitted. However, Registered Provider is aware of the need to give this matter careful consideration. Also, there are arrangements which should ensure that support workers are informed about the assistance each new service user will need. This is so that a new service user’s needs for support, can be met reliably from the start of his or her period of residence. The Inspector asked one of the service users about this aspect of the arrangements made when he moved into the Home. He considered that his needs for assistance had been met from the start. He said that this provision had been in line with his expectations. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. The health and personal care which service users receive, is based upon their individual needs. The principles of respect, dignity and privacy are put into practice. The arrangements used to ensure the personal safety of some of the service users, need to be strengthened. EVIDENCE: There are various systems in place to enable each service user to liaise with support workers in order to identify and to plan for the provision of the assistance they need. These measures include the preparation for each person, of a written individual plan of care. The service users said that they are involved adequately in the preparation and review of their individual plans. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 10 The Registered Provider and the support worker have a good understanding of the personal care to be provided for each of the service users. They provide this in a consistent and appropriate manner. The service users receive varying amounts of assistance to enable them to manage their financial affairs. The arrangements in place are sensible and suitable. There is an omission in one the arrangements used to assist some of the service users to avoid what might be a risk to their wellbeing. The Registered Provider should address this matter in the manner described in the relevant Required Development listed at the end of this Report. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16 and 17. Quality in this outcome area is good. This judgement is made using available evidence including a visit to this Service. Service users are able to choose their life style, social activities and to keep in touch with family and friends. Service users receive a healthy and varied diet according to their requirements and choice. EVIDENCE: All of the service users undertake a range of activities each week, some of which have an explicit vocational element. The service users say that they are satisfied with their respective calendars of activities. Each of the service users leaves the Service regularly in order to do various things such as going to shops. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 12 The Registered Provider and the support workers assist the service users to maintain contacts with members of their families. During the course of the inspection visit, the Inspector spoke with two of the service users’ relatives. They praised the quality of the care provided in the Service. They consider themselves to be consulted adequately. The pace of daily life in the Home is relaxed without there being any unnecessary rules or routines. The balance between things being orderly and people doing what, they want is about right. The service users said that they have appetising meals. The record of the food provided indicates that the service users have a normally varied and balanced diet. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. Service users’ personal and healthcare needs are met appropriately. Suitable arrangements are used to manage service users’ medication. EVIDENCE: The service users say that the support workers respect their individuality by recognising that each has their preferred way of doing things. For example, they said that within reason they can get up and go to bed as they wish. Also, that they can retire to the privacy of their bedrooms if this is their choice. The Registered Provider and the support workers keep a tactful eye on service users’ physical health. Arrangements are made for medical assistance to be sought as and when this is needed. Suitable systems are used to ensure that each service user takes medication in the manner intended by their doctor. The medicines are stored in a secure and orderly manner. Also, they are dispensed in accordance with the instructions received from the pharmacist. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 14 Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. There are systems which are designed to enable service users to make a complaint. Service users are protected from abuse, neglect and self harm. EVIDENCE: There is a complaints procedure which explains how someone can make a complaint about the facilities and services provided in the Service. Service users say that they consider themselves to be free to speak to a member of staff if there is something on their mind. The Registered Provider is aware of the need to investigate all complaints thoroughly. The Registered Provider has not received a complaint since the last inspection visit. Therefore, it is not possible to assess how well these arrangements work in practice. The Registered Provider and the support worker have a good understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances which might jeopardise the well-being of a service user. No one says that they had witnessed anything in the Service since the last inspection visit, which has given them cause for concern. The service users say that they feel safe living in Dalkeith Lodge. They are confident that the Registered Provider and the support workers will act in their best interests. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 16 Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. The accommodation enables the service users to live in a generally wellmaintained and comfortable environment, which promotes independence. There are several defects in the shower room. EVIDENCE: Service users say that they are comfortable living in their home. In general, the accommodation is welcoming and pleasant. However, the shower room is not finished to an adequate standard. The shower fixture is broken. Some areas of the wall finishes are poorly applied and so look to be unsightly. Also, there is discoloured length of copper pipe which runs around the interior of the shower enclosure at ankle height. The Registered Provider says that she is going to refurbish this room in the near future. At the very least, the items noted above will need to be addressed within the timescale established in the relevant Required Development listed at the end of this Report. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 18 Most of the accommodation was pleasantly warm when the Inspector was there. However, the ground floor shower room and the area outside were too cool for comfort. The Registered Provider should consider how best to rectify this matter when undertaking the refurbishment of the shower room. The Registered Provider has assessed how best to avoid the occurrence of a fire safety emergency in the Service. This exercise shows that there are no appreciable hazards which require special management. The Registered Provider is not sure that this document had been submitted to the Kent Fire and Rescue Service. This is important, because the assessment and management plan should enable the Kent Fire and Rescue Service to update its evaluation of the adequacy of the fire safety regime operated in the Service. The Registered Provider is going to clarify this matter and as necessary she will forward the assessment to the Kent Fire and Rescue Service. The kitchen is clean and well organised. Sensible food handling and general hygiene arrangements are in place. The Service is understood to comply with the principal requirements of the local Department of Environmental Health. All residential care homes now need to ensure the purity of drinking water. This means that steps have to be taken to prevent used water from leaking back from items such as washing machines into the main pipe-work. The Registered Provider is not sure if the necessary provisions are in place. She is going to clarify this matter, so that any necessary improvements can be made as soon as possible. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. The current staffing levels meet the minimum requirements only. Service users are assisted by members of staff who are appropriate and who are skilled suitably. EVIDENCE: There is at least one support worker on duty in the Service whenever any of the service users are at home. The service users said that they receive all the assistance they need. The Inspector thinks that the level of staffing resources provided currently is at the minimum. In the future, additional provision might need to be made in order to enable some of the service users to receive more periods of individual assistance. Various systems are in place to ensure that the support workers assist service users in a coordinated and consistent manner. This is very important because service users need to experience a reliable and predictable response to their needs for support. The Registered Provider is responsible for ensuring that all members of staff are trustworthy people, who are suitable to have unsupervised access to Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 20 service users. This involves completing various security checks in relation to prospective new employees. The Registered Provider is aware of her responsibilities in relation to this matter. The Inspector could not check this matter further, given the absence of any new appointment since the last inspection visit to the Service. The Registered Provider is responsible for ensuring that all support workers know how best to assist each of the service users. All new support workers receive introductory training. This is designed to ensure that they have the basic competencies necessary to enable them to work without direct supervision. However, in the absence of any new appointments, the Inspector could not examine how this arrangement works in practice. In addition to the introductory training, existing support workers undertake a number of training courses. These are designed to develop further their capacity to deliver care. The support worker with whom the Inspector spoke has a good understanding of the individual needs of each of the service users. Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. The management of the Service is effective. There is a basic quality assurance system. An aspect of the fire safety regime needs to be strengthened. EVIDENCE: The Registered Provider has a detailed knowledge of the daily running of the Service. She has professional and management qualifications which underpin her ability to manage effectively the Service. The service users say that the support workers consult them about their day to day lives in their home. This arrangement now needs to be complemented with a more organised approach. This will see the Registered Provider preparing a Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 22 written annual Quality Report. The Report will summarise any improvements suggested by the service users and it will explain what the Registered Provider intends to do in relation to them. The Registered Provider says that the first such Report will be completed by the end of 2007. The Registered Provider is completing various checks which are designed to ensure that the Service’s fire safety equipment remains in good working order. The support workers attend an annual fire training course. This arrangement needs to be strengthened. This is so that at least once every six months, their ability to operate the Service’s fire safety procedure is confirmed. This matter should be addressed in the manner described in the relevant Required Development listed at the end of this Report. The Registered Provider reviews regularly the premises and the service users’ accommodation. This is done so that any potential significant hazards which might cause someone to have an accident, are identified and addressed. The Inspector did not notice any obvious hazards when he was about the place. Dalkeith Lodge DS0000023389.V299958.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 Adults 18-65 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 2 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 X Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? 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 YA9 Regulation 13 Requirement Timescale for action 01/02/07 1. YA27 23 2. YA42 23 The Registered Provider should complete an organised assessment of the risks likely to be encountered by all of the service users who go out on their own. The Registered Provider should 01/06/07 replace the broken shower fixture, replace the unsightly wall sealant and should relocate (or cover) the exposed pipe-work, in the shower room. The Registered Provider should 01/02/07 ensure that all of the support workers are included within a suitable system which is designed to ensure their ability to operate reliably the Service’s fire prevention and fire safety procedures. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000023389.V299958.R01.S.doc Version 5.2 Page 25 Dalkeith Lodge Standard Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Dalkeith Lodge DS0000023389.V299958.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!