Inspection on 03/03/06 for Dalkeith Lodge

This inspection was carried out on 3rd March 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 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 22/12/06

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 Kim Rogers Unannounced Inspection 3rd March 2006 11:40 Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 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.V284149.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V284149.R01.S.doc Version 5.1 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 Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th November 2005 Brief Description of the Service: Dalkeith Lodge is a house set over 3 floors near to the centre of Herne Bay. There is an attractive garden to the rear and parking to the front of the house. The home has single and double rooms accommodating up to 8 service users. There is a large lounge and separate dining room. There is a bathroom upstairs and a shower room downstairs. Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out by one Inspector. The registered provider who is also the manager was at the home during the visit. The current manager has owned and run the home for 15 years. The Inspector spoke to 2 service users who were at home for part of the visit. The Inspector sampled some records including service user plans and staff files and had a look around. Information was organised and up to date and available to the Inspector. Most service users have lived at the home for several years. Service users appeared happy and relaxed. Service users access a variety of day services and amenities locally. This means that service users are out for much of the week. Some parts of the home were cold and in need of improvement. The manager agreed to address this. The home was generally clean on the day of the visit although there are cobwebs in some rooms. After speaking to service users and the manager and making observations the Inspector concluded that the home continues to provide service uses with the care and support they need. What the service does well: What has improved since the last inspection? The staff induction has been improved and is now in line with the National Minimum Standard. There have been replacement double glazed windows installed to the front of the property. Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 6 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.V284149.R01.S.doc Version 5.1 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.V284149.R01.S.doc Version 5.1 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 Service users cannot be sure their aspirations will be assessed. EVIDENCE: One service user has moved into the home since the last inspection. The Inspector looked at the assessment carried out by the home. The assessment was quite detailed and covered most of the areas identified as crucial by the National Minimum Standard. However, aspirations were not assessed. The Inspector required that aspirations be added to the assessment. The home is registered to provide personal care and support to adults from 18 to 65 years of age. One service user is over 65. To accommodate this person the manager must apply to the Commission for a variation to the registration. Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 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): 6,9 Service users know their changing needs will be recognised and supported. Service users know that potential risks will be identified and where possible eliminated. EVIDENCE: The Inspector sampled a service user plan. These are developed from the initial assessment. Needs are recorded with actions and interventions by staff to meet these needs. A risk assessment checklist is in place. Risks are supported by identifying potential risks and putting strategies in place to reduce any risks. There was evidence that service user plans are kept under review. This ensures that changing needs are recognised at an early stage and supported. A review prepared by a key worker in respect of one service user was very detailed and comprehensive identifying the person’s hopes for the future. Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 10 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): 11,12,13 Service users have opportunities for personal development. Service users have opportunities to enjoy a range of activities. Feeling part of the local community enhances service users lives. EVIDENCE: Service users communication needs are assessed initially then recorded in the service user plan. The same process is applied to social and emotional needs. Most of the service users attend the local church together. Most service users attend a day service and local clubs and amenities. This means that service users do not spend much time during the week at the home. The Inspector saw evidence that service users hobbies and interests are supported by the home. Some service users are friends with neighbours and have friends in the local community. A volunteer supports one service user to access the community one day a week. The volunteer arrived home with the service user during the Inspectors visit. The service user said he had been to the shops, which he said he enjoyed. The manager said that service users are supported to carry out household tasks like dusting and vacuuming. Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 11 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 Service users personal care needs are met. Service uses health needs are met. EVIDENCE: Personal care needs are detailed in service user plans and are kept under review. This ensures that service users are supported in a way they prefer. Each service user is registered with a local G.P. A record is kept of outcomes from appointments with health professionals. Health needs are recorded in service user plans. The Inspector was satisfied that service users have the support they need to access a full range of health services. The standard relating to medication was not assessed in detail. However records of medication administration were well recorded. The manager was able to give the Inspector detailed information about how the home procures and disposes of medication. The home uses the monitored dosage system provided by a local pharmacy. Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 12 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): 23 Service uses are protected from abuse. EVIDENCE: The home has an adult protection policy and procedures in place to respond to suspected abuse. Staff attend adult protection training during their induction. Care managers and relatives are invited to review meetings where any issues can be raised and discussed. Recruitment checks are carried out on staff to ensure they are safe to work with vulnerable adults. The manager said the home has received no complaints since the last inspection. Each room has some information about who service users can talk to. Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 13 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 EVIDENCE: New replacement double glazed windows have been fitted to the front of the property since the last inspection. The manager said this has reduced traffic noise and draughts and enhanced the look of the property. The property is in keeping the other properties in the area. Bedrooms are on the ground and first floor, which is accessed by stairs. There is also a stair lift fitted although current service users do not use this. Some bedrooms are for double occupancy and have a screen fitted for privacy. The manager said that service users have shared for some time and continue to make a positive choice to share. Some parts of the home could be improved to enhance service users lives. For example some of the wallpaper in service users rooms is tatty especially in the area around beds. Some bedrooms had cobwebs around the ceiling area, there was insufficient lighting on the landing and there were cloth hand towels in the bathroom. The ground floor shower room has no heating and felt very cold. The shower curtain was stained and unattractive giving an unwelcoming feel to the room. One service user plan recorded ‘X prefers to have a shower’ The Inspector required that the shower room be improved and that an audit be carried out of the décor and improvements made where necessary. There is a large lounge with separate dining room. There is a small visitors room, which overlooks the rear garden. Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 14 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 An effective staff team supports service users. Recruitment checks are robust, which protects service users. EVIDENCE: The home employs 7 staff including the manager. Staffing is planned around the needs of the service users. This means that staff are available when service users need them. The manager lives close by and is on call in case of an emergency. A volunteer supports one service user to access the community. Most of the service users are able to access the community on their own. There were 2 staff on duty on the day of the visit and one service user at home. Another service user arrived home with the volunteer. One staff sleeps in at night in a staff flat. The Inspector was satisfied that staffing is sufficient and effective. The Inspector looked at staff files. Information was well organised showing that proper recruitment checks are carried out before a person starts in post. Documentation required by legislation was present for the staff members picked at random. Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 15 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 This is a well run home. EVIDENCE: The manager is a qualified nurse and has owned and run the home for 15 years. The home has a family like feel as most of the service users have lived there for several years. This means the manager and staff know the service users very well. The manager spoke with understating of the need to promote and develop independent skills and the benefits of participation. Records required were present and organised. The manager has regular daily contact with staff and is available for advice and support in an emergency. The Inspector saw evidence that the manager meets regularly with staff on an individual basis. The inspector noted that there are some shortfalls in staff statutory training and asked the manager to audit staff training and plan to address the shortfalls. Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 16 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 2 2 2 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 2 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X X X X 2 X Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 17 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 2 Standard YA2 YA42 Regulation 14 18,12 Requirement Aspirations must be included in the assessment process. The manager must ensure that all staff have completed the statutory training required by this standard. The manager must carry out an audit of the home’s décor and address any needs identified. The shower room must be improved. The manager must apply to the Commission for a variation to the homes registration in respect of one service user. The manager must ensure there is sufficient lighting throughout the home. Timescale for action 30/04/06 31/08/06 3 4 5 YA24 YA27 YA1 23 23 3 30/04/06 31/08/06 30/04/06 6 YA42 12 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA30 Good Practice Recommendations A hygienic method of drying hands should be provided. DS0000023389.V284149.R01.S.doc Version 5.1 Page 18 Dalkeith Lodge 2 YA30 Cobwebs should be removed. Dalkeith Lodge DS0000023389.V284149.R01.S.doc Version 5.1 Page 19 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. 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