Inspection on 14/02/06 for Dalling House

This inspection was carried out on 14th February 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Dalling House 04/06/07

Dalling House 12/12/06

Dalling House 29/06/05

Dalling House 13/02/05

Dalling House 12/10/04

Dalling House 27/02/04

Dalling House 06/01/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Dalling House Croft Road Crowborough East Sussex TN6 1HA Lead Inspector Nigel Thompson Announced Inspection 14th February 2006 09:30 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 Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dalling House Address Croft Road Crowborough East Sussex TN6 1HA 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) 01892 662917 Aspenglade Limited Mrs Pamela Wickens Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of twenty one residents to be accommodated (21) The people accommodated will be aged sixty five years or over on admission 29th June 2005 Date of last inspection Brief Description of the Service: Dalling House is close to Crowborough town centre, within walking distance of shops, churches and buses. The home is registered for 21 older people. Seventeen single and two double bedrooms, many with en suite facilities, are situated on three floors and are served by a passenger lift. There is a through dining room and lounge with a sun room that looks out onto a well- maintained rear garden, with a water feature. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over five and a half hours in February 2006. It found that all of the National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Service users and relatives spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. On the day of the inspection there were seventeen service users living at the home. The inspection involved a tour of the premises, examination of the home’s records and discussion with the Registered Manager and Registered Provider. Three members of staff, seven service users and two relatives were also spoken with. The focus of the inspection was on the quality of life for people who live at the home. It is anticipated that within the next few months there will be new owners of Dalling House, however there is no firm date for this at present. In order that a balanced and thorough view of the home is obtained, this report should be read in conjunction with previous inspection reports. What the service does well: The relaxed, homely and welcoming environment has evolved over many years and reflects the stability and commitment within the staff team and the open and inclusive management style of the established and clearly dedicated Registered Manager. The level of care provided in the home, including meals and activities, continues to be of a high standard. This is reflected by the positive comments received from service users and their relatives, expressing a high degree of satisfaction with the home and the services provided. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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 Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 7 contacting your local CSCI office. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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 Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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, 2, 3, 4, 5 & 6 Documentation, including a concise information leaflet, statement of purpose and service users’ guide ensures that prospective service users and their relatives have sufficient information about the home and the services provided. However certain documents, including the service users’ guide need to be reviewed. The current admission policy and procedures are to be reviewed to ensure that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. EVIDENCE: Following an enquiry to the home, information is made available to prospective service users and their relatives in the form of a concise, illustrated leaflet, containing general information about the home and services provided. Although there is a statement of purpose in place, it is evident that it has not been recently updated and, as discussed with the Manager, it is required that it be reviewed and amended, in accordance with Schedule 1. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 10 The current service user’s guide is presented as a series of information sheets. Following discussion with the Manager, it is recommended that the format be reviewed and improved, with the possible addition of photographs, to provide a more concise ‘user friendly’ and readily accessible document. It is required that a copy of the revised service user’s guide be provided to each current and prospective service user. The current pre-admission assessment format is unsatisfactory and would benefit from being restructured and expanded, as discussed, allowing space for more detailed information and additional comments. It is also recommended that the revised format contain information regarding an individual’s social and recreational interests as well as specific details, as discussed, including the service user’s name, the identity of the assessor and the date of the assessment. The current ‘Terms and Conditions’ of residence are to be reviewed and amended to include updated contact details for the CSCI. Prospective service users are invited to the home and have the opportunity to look around and meet with staff and existing residents. They often stay for lunch. Initially a person moves into Dalling House on the basis of a month’s trial period. During this time their individual care and support needs can be more fully assessed and their compatibility and general suitability for the home is established. The Manager confirmed that intermediate care is not currently provided at Dalling House and emergency or unplanned admissions are avoided. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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 Service users’ personal, emotional and ongoing care and support needs are not always fully met, as individual care plans are not consistently well maintained or regularly reviewed and amended to reflect changes in need or circumstances. Policies and procedures for the control and administration of medication are effective with clear and comprehensive systems being in place to ensure service users’ medication needs are met. EVIDENCE: Individual care plans have been developed for each service user, however there is little evidence of any clear and direct link to their assessed needs. Plans that were inspected were found to be poorly maintained, containing original details of action to be taken by staff, dating back to the individual’s admission to the home. In one case there was no documentary evidence that details had been reviewed or any changes recorded since November 2004. All service users are registered with local GPs and have access to other health care professionals, including district nurses, via the surgeries. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 12 Satisfactory policies and procedures are in place for the control, storage, safe administering and recording of medication. The Manager confirmed that all staff involved in administering medicines receive appropriate training from a local pharmacist who visits the home on a regular basis to monitor the relevant policies and procedures. This was confirmed by members of staff spoken with during the inspection and from training records examined. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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 & 15 Family and community links are good and support and enrich service users’ social opportunities. Social activities and meals are both well managed, creative and provide daily variety and interest for people living in the home. EVIDENCE: Although there is currently no structured programme of organised activities, outings and events, there is evidence that the home provides a range of inhouse activities such as bingo, quizzes and musical entertainment on a regular basis. Video or DVD afternoons are also popular in the home, as are the weekly massage, musical movement and gentle exercise sessions. Service users are encouraged and supported to maintain family links and the Manager confirmed that visiting to the home is unrestricted with friends and relatives made welcome at any time. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 14 Varied, balanced and nutritious meals are provided, reflecting service users’ choice and preferences. An alternative to the main meal is available on request and special diets, including diabetic meals are catered for. The experienced cook confirmed that service users are consulted and directly involved in compiling the four-week rolling menu. Service users, spoken with over lunch, confirmed the general high standard of the meals: ‘The food is always good and there is so much of it’. ‘As you can see, we eat well here!’. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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): These standards were not inspected on this occasion. All key standards were assessed during the previous inspection carried out on 29 June 2005. EVIDENCE: Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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 24, 25 & 26 The service is accessible, safe and clean and is clearly suitable for it’s stated purpose. Service users benefit from pleasant accommodation that is comfortable, generally well maintained and decorated to a satisfactory standard. EVIDENCE: Standards relating to the physical environment remain largely unchanged. Service users’ accommodation comprise of nineteen bedrooms on three floors, easily accessible by a large passenger lift. The majority of rooms have en-suite facilities and all are fitted with call bells and were found to be clean, comfortable and furnished and decorated to a satisfactory standard. The Manager confirmed that, as far as is practicable, independence and individuality continue to be promoted within the home and this is evident from the personalising of service users’ rooms, which clearly reflects individual tastes, interests and preferences. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 17 A pleasant dining area provides a relaxed, homely and sociable setting for meal times. The dining area leads through to a comfortable lounge and a separate solarium. A ramp provides easy access into the well maintained rear garden. All communal areas are furnished and decorated to a high standard. The heating system is effective and lighting throughout is domestic in character. Infection control procedures are in place and clearly adhered to and levels of cleanliness remain high throughout. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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): 29 & 30 There are sufficient trained and competent staff on duty at all times to meet the assessed needs of the service users. Some unsatisfactory recruitment procedures, including documentation, do not always help to ensure the safety and protection of service users. EVIDENCE: Since the previous inspection, a training matrix has been developed and implemented and clearly shows at a glance the specific training individual staff members have undertaken and when. As a result of this it was evident that the majority of staff have not received up to date training regarding the Protection of Vulnerable Adults (POVA). This was discussed with the Manager, who is to ensure that relevant training is provided for all staff. Staff files that were examined were found to be well generally maintained, containing all necessary information, including two written references, proof of identity and satisfactory Criminal Record Bureau (CRB) and POVA checks. However it was noted that several application forms had not been completed satisfactorily and there were gaps in certain areas, including employment history. There was also very little space provided for the applicant’s ‘reasons for applying for the post’. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 19 Following discussion with the Registered Manager and the owner it is recommended that the format of the application form be reviewed and amended. It was noted in staff files that were examined, the Statement of Terms and Conditions of Employment had been signed by the member of staff and by the Manager or owner, on behalf of Dalling House. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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 & 36 Service users and staff benefit from the Manager’s experience and her open and approachable style of leadership. However, formal staff supervision has still to be introduced. Service users benefit from the quality assurance and self-monitoring systems in place at Dalling House. EVIDENCE: The established and experienced Manager has been in her current post since 1984. She evidently continues to maintain a relaxed, open and inclusive atmosphere within the home. Staff and service users, spoken with during the inspection confirmed how approachable and supportive the Manager is. Since the previous inspection, as required, effective quality monitoring systems in the home have been introduced. The Manager confirmed that satisfaction Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 21 questionnaires have been distributed to service users, their relatives and health care professionals associated with the home, including GPs, CPNs and district nurses. Positive responses to this recent survey expressed a high degree of satisfaction with the home and the services provided. Typical comments included: ‘The levels of care and compassion are excellent’. ‘As far as I’m concerned, the home is exemplary’. ‘Excellent care provided at all times’. Comment cards from service users’ relatives, received prior to this inspection, reinforced this positive view of the home: ‘My mother could not be happier! Care is superb – Brilliant! I hope the new owners keep I the same, with the same staff’. As discussed with the Manager, it is recommended that satisfaction questionnaires be dated. Despite previous requirements, there is still no evidence that formal staff supervision is being provided. The Registered Manager is due to retire in the near future and is proposing to leave Dalling House at the same time as the present owners, on the completion of the sale of the home. In these circumstances, therefore, it is unlikely that formal supervision will be introduced until a new Manager is appointed. Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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 2 2 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 X X X 3 3 3 STAFFING Standard No Score 27 X 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 2 X X Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4 (1) © & Schedule 1 5 (2) Requirement It is required that the statement of purpose be reviewed and amended, in accordance with Schedule 1. It is required that a copy of the revised service user’s guide be provided to each current and prospective service user. It is required that, to ensure an individual’s healthcare needs continue to be met, that the assessment of those needs is kept under review. It is required that service users’ care plans be regularly reviewed and updated, to reflect an individual’s current care and support needs. It is required that formal staff supervision sessions be introduced for all care staff. (Previous timescales of 01/04/05 & 31/08/05 not met) Timescale for action 31/05/06 2. OP1 31/05/06 3. OP3 14 (2) 31/05/06 4. OP7 15 (1) (2) 31/05/06 5. OP36 18(2) 31/05/06 Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 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 OP1 Good Practice Recommendations It is recommended that the format of the service user’s guide be reviewed and improved, with the possible addition of photographs, to provide a more concise ‘user friendly’ and readily accessible document. It is recommended that the current ‘Terms and Conditions’ of residence be reviewed and amended, to include updated contact details for the CSCI. It is recommended that the pre-admission assessment be reviewed and amended, as discussed, to include more detailed information. It is recommended that the format of the staff application form be reviewed and amended, as discussed. It is recommended that all staff receive specific up to date training regarding the Protection of Vulnerable Adults (POVA). 2. 3. 4. 5. OP2 OP3 OP29 OP30 Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Dalling House DS0000021085.V267119.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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