Inspection on 15/05/07 for Dalmeny House

This inspection was carried out on 15th May 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Dalmeny House 02/06/09

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

CARE HOME ADULTS 18-65 Dalmeny House 2 The Boulevard Sheringham Norfolk NR26 8LH Lead Inspector Mrs Marilyn Fellingham Unannounced Inspection 15th May 2007 10:00 Dalmeny House DS0000065759.V340229.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 Dalmeny House DS0000065759.V340229.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. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dalmeny House Address 2 The Boulevard Sheringham Norfolk NR26 8LH 01263 822355 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) dalmenyhouse@btconnect.com Dalmeny House Ltd Mrs Gillian Mary Simpson Care Home 11 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (11), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (2) Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th. November 2005 Brief Description of the Service: Dalmeny House is a care home providing personal, therapeutic care and accommodation to eleven adults with mental disorders. It is owned by Mr Colin Simpson and Mrs Gillian Simpson. Whilst Gillian Simpson is the registered manager, Colin Simpson is also actively involved in running the care home. It is situated in the centre of the seaside town of Sheringham and is close to all local amenities, including shops, pubs, post office and public transport. The property is a large semi-detached Victorian house that offers accommodation on three floors. It has a large garden, patio and decking area. The home comprises of eleven single bedrooms and all are en suite. The home is well maintained throughout and provides good quality and comfortable accommodation. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over five and a half hours. Eight comment cards were received from service users, one relative and one professional; all the feedback was most positive. Some of the comments were, for example “I am happy here; my life is now on track.” “I am happy here and I have made progress and will be moving to more independent living soon.” “The carers do care always.” The proprietors of Dalmeny House have an extensive background in Mental Health care. All aspects of this home are excellent. The residents are well cared for, always well motivated, there are plenty of activities and Mr and Mrs Simpson are very caring and run an excellent home. The staff are experienced and look after their residents in a very caring sensible and responsible manner. The manager Gillian Simpson and her husband Colin were in the home during the inspection process. Three staff members were also present as were nine of the service users. A tour of the home took place and the opportunity was taken to examine staff and service user records including some care plans. This is a comfortable and pleasant home that offers excellent care. What the service does well: The home has a very cohesive group of staff who have worked with the Simpson’s for a long time. The home is always adequately staffed and this allows the residents to pursue many of their chosen activities. The home is comfortable, safe and well maintained. Mr and Mrs Simpson and the staff support the service users who indicate that they feel in safe hands, this is due in part to the overall ethos of the home and the management style. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 6 The home continues to provide an exceptionally caring home and service users are carefully assessed before admission. 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. Dalmeny House DS0000065759.V340229.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 Dalmeny House DS0000065759.V340229.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Persons who use the service have adequate information to make an informed decision about admission to the home. Service users are assessed before admission to the home, the assessment process is comprehensive. EVIDENCE: The statement and service users guide was seen to provide all the information that is needed for prospective service users to make an informed choice about the home. All new service users are assessed before admission to the home, information is collected from the various professional agencies that are involved with the client; this is very detailed with a history of various risks associated with the client that might pose a problem on admission to the home. The prospective service users are then assessed over a period of time sometimes making many visits to the home, this way the home can be sure that the needs of the client can be met and it also gives the prospective service users time to try out the home and mix well with the other residents. This is paramount in order to maintain the ethos and aims and objectives of the home. A newly admitted service user confirmed that they had been given sufficient information to make an informed choice about entry to the home. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 9 Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are good, clear and informative care plans in place. Service users are encouraged to lead independent lifestyles that include taking responsible risks to achieve this. EVIDENCE: Care plans are in place for all service users, four were examined by the Inspector; these were found to be clear and detailed and related to the assessed needs of the service users. These care plans reflected the service users individual goals and therapeutic intervention. It was noted that there had been continued evaluation of care with records of multidisciplinary intervention. There were detailed daily notes with some of these entries being entered on the care plans when changes in needs arose. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 11 There was evidence of service user involvement in the care planning system and this was also confirmed by those service users whom the Inspector spoke to. Risk assessments were in place and service users are encouraged to take risks responsible risks as part of their goals to develop more independent skills for living. The service users readily indicated to the Inspector that they were well supported and enabled to achieve more independence. The manager informed the Inspector that they have resident’s meetings and minutes for these were seen; the service users themselves stated that they felt that they were always encouraged to be involved in the day to day running of the home and that their views about the home are noted and quite often acted upon. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Activities and meals are managed extremely well. The service users are encouraged to be in control of their own lives, enhance their social skills and at the same time developing personally. EVIDENCE: Discussion with staff and the service users confirmed that opportunities were given to them to encourage them in their personal development and engage in fulfilling activities. In her discussions with the service users the Inspector was given many examples of all the activities that they can take part in if they so choose. The home has a full membership to a local gym where the service users can take part in physical activities including swimming and badminton. On the day of inspection one service user had been working at a local farm and then went on to play five a side football. Another service user helps out at the local Salvation Army for two mornings a week. Many more examples Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 13 were given to the Inspector and the service users were most enthusiastic about all the activities that they could take part in. The service users said that there were always things to do every day and evenings if they wanted to. The home needs to be commended for this. One service user explained that he saw his girlfriend whenever he wanted to and often went to visit her or she visited him. Some of the service users were excited about going on holiday for a week at a nearby seaside resort and were planning what they needed to pack; it was noted that the staff were helping them in the decision making process. It was felt generally that the meals were good and that there were always choices available, one service user pointed out that the home was very good at catering for diabetics. The menus have changed just recently and this was in direct response to a survey the manager did regarding the food. All the comment cards received made very positive comments about the home. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are well supported by staff. Those service users living in the home are protected by the home’s policy and procedures for administering and handling medication, however more care is needed in ensuring that the medication records are completed appropriately. EVIDENCE: Discussion with the service users confirmed that they were very well supported by all levels of staff. Only one service user requires physical support and this is seen in his overall intervention for care. Some service users self medicate and risk assessments were seen for this activity; it was also noted that these risk assessments are updated to accommodate any change in the assessed risk. Those service users who self medicate have a lockable facility in their rooms to accommodate their medication. Those staff spoken to were aware of the policies and procedures for handling and administrating medication. One medication record chart seen by the Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 15 Inspector had numerous gaps for Lactulose and it was therefore difficult to ascertain if this had been given or not. The Inspector noted that all medication received into the home is recorded and monthly audits of medication are also carried out. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel that they are listened to. The home has policies and procedures in place for protecting the service users from abuse. EVIDENCE: Those service users spoken to felt that their views are listened to and one example of this as already mentioned was the change in menus. The service users also express their views and indeed are encouraged to at the residents meeting which are held once a month or more if necessary. They also felt that they could talk to any member of staff. Staff spoken to were aware of the policy and procedures for making a complaint and also aware of the whistle blowing procedure. All the staff have had training in the protection of vulnerable adults. Dalmeny House DS0000065759.V340229.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users live in a very comfortable, homely and safe environment. The home is exceptionally clean and hygienic. EVIDENCE: The home was found to be very clean and tidy and the service users said that they were very satisfied with their accommodation. Those rooms seen by the Inspector were suitable for the clients who live in the home and it was noted that they had all been personalised. The home was in a good state of repair inside and outside and no hazards were detected during a tour of the premises. One service user commented that it was just like living at home. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users benefit from a well trained and cohesive staff team. EVIDENCE: Discussion with staff members confirmed that they felt that they were extremely well supported by the management and that they were clear about their roles within the home. All staff spoken to were adamant that they loved working in the home and that they were given many opportunities to increase their knowledge and skills in order to meet all the needs of the service users. The staff team are a very cohesive group who have worked with each other for a long time and with this particular client group. Training records were examined and 60 of the staff have NVQ level 2 or above. Formal supervision is in place and these sessions are used, as a format for discussing individual training needs as well as other professional areas that encompass the home’s philosophy. Only one member of staff has been recruited since the last inspection; the records for this were examined and all the necessary checks had been made and two references obtained. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 19 Duty rosters indicated that the home is always adequately staffed and on the day of inspection there were eleven service users with three carers, the manager and her husband. This good use of staff allows for the many activities that are scheduled to take place. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well managed home and are safeguarded by its policies and procedures. EVIDENCE: Examination of records, discussion with the staff and service users and comments on comment cards led the Inspector to form the opinion that the home is very well run. The owners Colin Simpson and his wife Gillian Simpson( who is also the registered manager) are very active members of the overall staff team and this involvement along with the ethos of the home definitely benefits the staff and the service users. The Simpson’s are very keen to promote good safe working practices and the documentation examined by the Inspector confirmed this. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 21 The records examined were written evidence of regular fire tests and the lift had been serviced the week prior to the inspection. Risk assessments of the environment were also seen. All staff have had updates in relation to food hygiene and first aid. The home keeps a record of all accidents in the home and audits are carried out. Surveys are used to monitor the quality of the service. Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 22 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 4 33 x 34 4 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 4 12 4 13 4 14 x 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 x 3 x x 3 x Dalmeny House DS0000065759.V340229.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA20 Good Practice Recommendations Records for administration of medication must be appropriately filled in; this will prevent medication errors being made such as overdosing. 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