Inspection on 11/02/08 for Dallington House

This inspection was carried out on 11th February 2008.

CSCI found this care home to be providing an Good service.

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

Dallington House 29/01/09

Dallington House 22/02/07

Dallington House 25/11/05

Dallington House 22/08/05

Dallington House 09/05/05

Dallington House 23/02/05

Dallington House 13/12/04

Dallington House 09/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Byars Care Home

St Marys Nursing Home

Jubilee Villa Care Home

Bramble Lodge

Parkmanor Residential Home

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

CARE HOMES FOR OLDER PEOPLE Dallington House 228 Leicester Road Enderby Leicestershire LE9 5BF Lead Inspector Kim Cowley Unannounced Inspection 2:00 11 February 2008 th 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 Dallington House DS0000001786.V341814.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. Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dallington House Address 228 Leicester Road Enderby Leicestershire LE9 5BF 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) 0116 2750280 0116 2750280 hdave@hotmail.co.uk Mr Harshavadan Dave Mrs Rashmi Dave Mr Harshavadan Dave Care Home 16 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8), Old age, not falling within of places any other category (16) Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Minimum age of admission in category LD is 55 years. Service User Numbers. No person to be admitted to the home in categories LD(E) or LD when 8 persons in total of these categories/combined categories are already accommodated within the home. Service User Numbers. To be able to admit the person of category MD(E) identified in correspondence from the previous registration authority dated 09/05/01. Service User Numbers. To be able to continue to provide care to two service users, as identified in correspondence with the National Care Standards Commission dated 13th January 2004, who fall within category MD(E) and who weren’t living in the home prior to the 1st April 2002. To admit a named person into the home. 3. 4. 5. Date of last inspection 22nd February 2007 Brief Description of the Service: Dallington House is situated on the Leicester Road in Enderby, next to the ‘Foxhunter’ roundabout. It is on the main bus route into Leicester, and close to the train station at Narborough, where the nearest local shopping area is also situated. The home is a detached property and provides care for 16 older people, including eight places for residents with learning difficulties aged 55 years and older. Accommodation is on two floors and with access to the first floor via a stair lift. There is a large lounge on the ground floor, which overlooks the garden. This leads to a dining room and a small conservatory. Bedrooms are on the ground and first floors. Fees range from £269 to £389 per week depending on a resident’s needs. Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a key inspection that included a visit to the home and inspection planning. Prior to the visit, the inspector spent half a day reviewing information relating to the home. During the course of the inspection, which lasted four hours, the inspector checked the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means the inspector looked at the care provided to three residents living at the home by meeting them; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were examined. The inspector also met three other residents, the Owner/Manager, two senior carers and one carer. What the service does well: The home has a friendly atmosphere and the residents appear to get on well with each other and the staff. Some activities are provided for residents. These include armchair exercise classes, floor games, bingo, and karaoke. In discussions residents said they liked socialising in the home. One resident said she was looking forward to the summer months, as she liked to sit outside in the gardens. Menus showed that a wholesome and varied diet is provided and there are choices at every meal. The food served is mainly English, with some Asian meals prepared, or bought in from a local restaurant. All residents interviewed said they liked the food. One commented, ‘The breakfast, lunches and teas are excellent.’ Communal areas and bedrooms are homely and comfortable and the home is well maintained. All areas inspected were cleaned to a high standard, and also tidy, warm, and fresh. Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 6 Records showed that some residents have improved since being in the home, for example, by becoming more mobile and being able to communicate more effectively. This had been acknowledged by outside health and social care agencies, and helps to demonstrate that good care is being provided. The home has a small established staff team. Turnover is low and agency staff are not used, so residents benefit from continuity of care and get to know their carers well. All the residents interviewed praised the staff team and the following comments were made, ‘The staff are kind’, ‘I like talking to the staff’, and ‘The staff are lovely and they are very good to me.’ 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. The summary of this inspection report can be made available in other formats on request. Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 7 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 Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 8 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): Quality in this outcome area is good. Residents’ needs are assessed prior to admission to ensure the home is suitable for them. This judgement has been made using available evidence including a visit to this service. (Standard 3 was inspected.) EVIDENCE: People who are interested in coming to the home have their needs assessed by a senior member of staff. This means they are visited in their homes or in hospital, or they come to Dallington House, where the Manager or Deputy look at the sort of care or support they might need. The end result – a written assessment – sets out their needs and shows whether or not the home is suitable for them. Three assessments were examined. All were detailed and contained the information staff needed to make a judgement about the suitability of the home for the person in question, including their ethnicity and cultural background. This will help to ensure that all a resident’s needs are met as soon as they move into the home. Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 9 Standard 6 was not inspected, as this home does not provide intermediate care. Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is good. Staff in the home, and in the wider community, meet residents’ health and personal care needs. Risk assessing and accident recording is in need of improving. This judgement has been made using available evidence including a visit to this service. (Standards 7, 8, 9, and 10 were inspected.) EVIDENCE: Since the last inspection new care plans, which set out residents’ needs, have been introduced. Those inspected were examined and found be detailed and provide clear information to staff on how best to care for residents. Records showed that some residents have improved since being in the home, for example, by becoming more mobile and being able to communicate more effectively. This had been acknowledged by outside health and social care agencies, and helps to demonstrate that good care is being provided at the home. However, risk assessments are in need of improvement. For example, one resident said he had recently had a fall and this was recorded in the accident book. However, when his care plan was examined, his risk assessment for Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 11 falling was dated 2004 and had not been reviewed since then. Another resident’s risk assessment for falling (also dated 2004, but reviewed at the end of 2007) stated they need a carer to help them mobilise ‘most of the time’. But it didn’t indicate how staff are supposed to know when this is. Risk assessments must be regularly reviewed, and there must be evidence that this has taken place, even if no changes are made. And they must contain all the information staff need to care safely and effectively for residents. This will help to reduce risk in the home. Care plans showed that residents’ health needs are promptly met and GPs, District Nurses, and other health and social care professionals are involved where necessary. The accident book was examined. Some of the records were acceptable, but others were not. For example, reference was made to staff ‘lifting’ residents after a fall, and there was no record of staff checking residents for injuries after they had fallen. This was discussed with the Manager. He said that staff never lifted residents, they always used the hoist, and that residents were always examined for injury after a fall. However he accepted that this was not always recorded in the accident book and that the records, as they stood, gave a misleading version of events and the impression that staff and residents were being put at risk. He said he would meet with his staff and explain to them how to complete accident records correctly. This will help to ensure that staff are responding appropriately when accidents occur. At the last inspection excess stocks of medication that should have been returned to the pharmacist were found in the home. Since then medication systems have been reorganised and improved. The medication returns book was examined and was up-to-date, showing that unused medication had been returned promptly to the pharmacist. This will help to ensure that medication is kept and administered safely. During the inspection staff were observed caring for residents in a discreet and respectful manner. Relationships between staff and residents appeared warm and friendly, and all residents interviewed praised the staff team. (See also Standards 27 – 30.) Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. Residents’ social and cultural needs are identified and met. This judgement has been made using available evidence including a visit to this service. (Standards 12, 13, 14, and 15 were inspected.) EVIDENCE: The home has a friendly atmosphere and the residents appear to get on well and to have formed friendship groups. Some activities are provided for residents. These include armchair exercise classes, floor games, bingo, and karaoke. Once a month outside entertainers come into the home and put on a show for the residents. In discussions residents said they liked socialising with each other and the staff. The majority of the residents go out on occasions to day centre, with relatives, and on shopping trips with the Manager. A few residents do not go out at all due to their frailty. One resident said she was looking forward to the summer months as she liked to sit outside in the home’s gardens. Menus showed that a wholesome and varied diet is provided and there are choices at every meal. Staff are aware of residents’ likes and dislike, and of any particular dietary requirements they have. This information is also recorded in residents’ care plans. The food served is mainly English, with some Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 13 Asian meals prepared, or bought in from a local restaurant. All residents interviewed said they liked the food. One commented, ‘The breakfast, lunches and teas are excellent.’ Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. Residents and their relatives are encouraged to talk to staff about any concerns they might have. This judgement has been made using available evidence including a visit to this service. (Standards 16 and 18 were inspected.) EVIDENCE: There is a complaints policy and procedure on display in home. This tells residents and their representatives what to do if there is anything they are unhappy about. It was acknowledged that, due to their disabilities, not all residents would be able to use this procedure. The Manager said staff were able to advocate for these residents and let others know if they appeared unhappy about any aspect of their care. All residents who were able to give their views said they would speak out if they had a complaint. One said, ‘I have lots of visitors and if there was anything wrong I would tell them’, and another commented, ‘If I had a complaint I would tell the staff.’ Records showed there had been no complaints since the last inspection. Staff have been trained in adult protection and were aware of their responsibilities to safeguard older people. One carer told the inspector that he would report any suspected abuse immediately to a senior member of staff or the Manager, and ensure that it was properly followed up. However, the home’s safeguarding policy needs to be updated, as at present it does not make clear the role of social services in safeguarding investigations. This will Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 15 help to protect residents by ensuring that a multi agency approach is used if abuse is suspected. Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents live in an environment that is safe, comfortable, and well maintained. This judgement has been made using available evidence including a visit to this service. (Standards 19 and 26 were inspected.) EVIDENCE: At the centre of the home is a large lounge where residents tend to congregate during the day. It has a good range of easy chairs, so residents can chose where to sit, and looks out over the home’s secluded gardens. Off this lounge are the dining room, and a small conservatory. These communal areas were homely with a range of pictures and ornaments on display for residents to look at. Six bedrooms were inspected and all were personalised and well decorated. Since the last inspection the following improvements have been made to the environment: • There is new furniture in the lounge DS0000001786.V341814.R01.S.doc Version 5.2 Page 17 Dallington House • • The entrance hall, stairs, and first floor corridors have had new carpets laid The downstairs bathroom has been completely refurbished and made more suitable for residents with limited mobility Care staff are responsible for the cleaning, and although they have to balance this with their caring responsibilities, they evidently do an excellent job. All areas of the home inspected were cleaned to a high standard, and also tidy, warm, and fresh. Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. An established staff team meets residents’ needs. Relationships between staff and residents are warm and caring. This judgement has been made using available evidence including a visit to this service. (Standards 27, 28, 29, and 30 were inspected.) EVIDENCE: The home has a small established staff team. Turnover is low and agency staff are not used, so residents benefit from continuity of care and get to know their carers well. All the residents interviewed praised the staff team and the following comments were made, ‘The staff are kind’, ‘I like talking to the staff’, and ‘The staff are lovely and they are very good to me.’ Three staff files were examined. All the required information was in place including satisfactory CRB/POVA checks and written references. This will help to ensure that residents are safeguarded. Staff training records are in need of improvement. The training matrix, displayed on the office wall, is out of date, so it is difficult to work out which member of staff has done which training course. In addition, some training has not been properly recorded. For example, the Manager said staff had been trained in the used of the hoist by the District Nurse, but there was no record of this. All training must be recorded so it is clear that staff are competent to carry out their duties. Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. The home is well run in the best interests of residents by an experienced Manager. This judgement has been made using available evidence including a visit to this service. (Standards 31, 33, 35, and 38 were inspected.) EVIDENCE: The Manager, who is also one of the Owners, has been in post since 1993. He works full time in the home and is currently studying for NVQ 4 in Care and the Registered Managers Award. He is knowledgeable about the needs of all the residents. A senior carer said, ‘He (the Manager) is in the home every day and you can go to him if you have any problems.’ Relationships between the residents, the staff, and the Manager appeared good. As the home is relatively small, everyone knows each other, and this daily interaction makes it easier for residents’ views to become known. In Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 20 addition, staff are mindful that some residents have different ways of communicating their views, and take this into account when decisions about the home are made. The Manager helps a small number of residents manage their finances. Where this is done appropriate records are kept, and these are double signed by the Manager and a senior member of staff. This will help to ensure that residents’ finances are managed properly. Staff files also showed that most staff have undertaken training in mandatory health and safety subjects. Staff spoken with, were aware of health and safety procedures and commented positively on the training provided. Arrangements for health and safety in the home are generally good, although first aid training is in need of review. At the inspection it was unclear which staff have been trained in first aid and when, or whether they training they had had was appropriate for their role. The Manager agreed to review first aid training and to ensure that at least one member of staff on each shift is first aid trained, and that their training is up to date. Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 21 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 15 Requirement Risk assessments must be regularly reviewed and contain all the information staff need to care safely and effectively for residents. This will help to reduce risk in the home. Recording in the accident book must be improved so that a clear account is given of what occurred, and what action staff took. This will help to ensure that staff are responding appropriately when accidents occur. The home’s safeguarding policy needs to be updated, as at present it does not make clear the role of social services in safeguarding investigations. This will help to protect residents by ensuring that a multi agency approach is used if a concern is raised. All staff training must be recorded so it is clear that staff are competent to carry out their duties. Timescale for action 11/03/08 2 OP7 17(1)(a) 11/02/08 3 OP18 13(6) 11/03/08 4 OP30 18(1)(a) 11/03/08 Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 23 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 Standard Good Practice Recommendations Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 © 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 Dallington House DS0000001786.V341814.R01.S.doc Version 5.2 Page 25 - 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!