Inspection on 18/05/05 for Dalmuir Home

This inspection was carried out on 18th May 2005.

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

Dalmuir Home 11/10/07

Dalmuir Home 01/02/07

Dalmuir Home 24/10/05

Dalmuir Home 30/09/04

Dalmuir Home 05/05/04

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 Dalmuir Home 25 Gresham Road Limpsfield Oxted, Surrey RH8 0BU Lead Inspector Mr D Ramdas Unannounced 18th May 2005 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 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. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Dalmuir House Address 25 Gresham Road Limpsfield Oxted Surrey RH8 0BU 01883 715630 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Mike Noorbaccus Mr Mike Noorbaccus Care Home 16 Category(ies) of DE - Dementia (1) registration, with number of places DE(E) - Dementia over 65 (11) LD(E) - Learning Disability over 65 (2) OP - Old Age (16) Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 2. Of the 16 older persons (OP) accommodated, up to 12 persons may fall within the category DE(E) 3. The age/age range of the persons to be accommodated will be : OVER 65 YEARS OF AGE 4. Of the 16 older people accommodated, up to 2(TWO) may be in the category LD(E), learning disability 5. Of the people accommodated with dementia 1 may be under 65 Date of last inspection 30th September 2004 Brief Description of the Service: Dalmuir House is a care home for older people that is located in Oxted in Surrey. The property is situated in a quiet residential area close to the town centre and public amenities. The accommodation is provided on three floors and stair lifts are available. The home can accommodate sixteen service users in single and shared bedrooms some with en suite facilities. The home has a dining room, lounge, kitchen, laundry, bathing and washing facilities. The gardens are well maintained comprising of lawns, flowerbeds, mature fruit trees and a vegetable garden. Private parking is available to the front of the property. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by one inspector over a period of six hours. A tour of the premises took place and staff, service users and relatives were spoken to. Care records and other documents were inspected. Comment cards, a business card and other information about the Commission were given to staff. The inspector would like to thank the service users, staff and relatives for their contributions during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home must improve the quality of furnishings in the lounge by replacing the fabric on the chairs to make it more pleasant for service users. Risk assessments must be done for medications such as creams and ointments that are left unattended in the service users bedroom to ensure service users are not placed at unnecessary risk. The finish on the flooring in the laundry must be made impermeable to help prevent cross infection. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 6 The home must improve the way in which supervision is arranged by ensuring staff have a named supervisor to do their supervision and ensure all cases of MRSA and Grade 2 pressure sores are reported to the Commission. 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. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3. Service users and prospective service users are provided with sufficient information to make an informed choice about admission to the home. The home must update and amend the Statement of Purpose. Service users had written contracts. Assessments at the home were good ensuring service users needs were adequately assessed and met. EVIDENCE: The home had a Statement of Purpose and Service User Guide. They contained information about the home such as the mission statement, aim and objectives, philosophy of care, services and facilities on offer, social and leisure activities and complaints. The inspector noted the complaint section was in need of updating to reflect a complaint could be made to the Commission at any stage, should the complainant wish to do so. The home also had a brochure that contained pictures of the home. The manager stated service users had written contracts. The inspector sampled the contracts and found they were dated and signed. One contract was dated the 31st May 2003 and signed by a relative. The home had an assessment based on a nursing model used to assess and identify the needs of service users. It covered areas of personal care, diet and weight, sight and hearing, continence, medications, mental state, social interest, falls, personal safety and risk. One relative stated her husband was admitted to the home three weeks ago and she was happy Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 9 with the admission process. She remarked, the manager was helpful and provided transport for her husband to visit the home prior to admission. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The health and personal care needs of service users are well met with evidence of good working with other health care professionals on a regular basis. Care plans were in place for service users. The home must improve procedures for reporting notifications to the Commission. EVIDENCE: The deputy manager stated the home had care plans. The inspector sampled the care plans and noted they reflected the health and personal care needs of service users. One service user had a diagnosis of MRSA. The inspector noted the Commission was not notified. Service users had named key workers and were registered with a GP. Dental, optical and chiropody care was offered on the NHS or privately, if required. There was evidence of the involvement of other health care staff in the planning of care. The inspector noted one service user that had a pressure sore was referred to the district nurse who completed a Waterlow assessment and a care plan. Another service user that had a problem with incontinence was referred to the continence advisor who completed an assessment and care plan. Staff respected the privacy and dignity of service users. The inspector noted staff referring to service users by their preferred names. One service user had a telephone in her bedroom to take telephone calls in private. The deputy manager asked service users for permission before entering their bedrooms and was observed to knock on bathroom and toilet doors before entering. One visitor who had a friend at the Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 11 home stated staff did not always switch on her hearing aid and that some items of her underclothing had been mislaid. This was discussed with the manager who stated he would investigate the situation and review the care plan. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,15 Dietary needs of service users are well catered for with a balanced and varied selection of foods available that meets service users tastes and choices. The home supports service users to maintain community contact. EVIDENCE: The manager stated friends and families are welcome at the home anytime but discretion is requested during meal times and late evenings. The inspector noted this was reflected in policy of the home. During the inspection two visitors arrived at the home. Service users stated the local priest visited regularly. This was reflected in the Visitor’s Book. The home had a Community Carer Commendation for involvement in the community. The home employed a fulltime cook that had a City and Guilds qualification in catering. The dining room was pleasant and tables were appropriately laid with knife, forks, spoons and condiments. The inspector noted the menu of the day was written on a board that was in the dining room. Meals were prepared in the kitchen and served in individual portions. The menu was varied, well balanced, healthy and offered choice. On the day of the inspection service users had a lunch of beef boguiane, potatoes and carrots. Dessert was fresh fruit salad or pineapple sponge with custard. Meals were nicely presented and tea, coffee and soft drinks were available throughout the day. Staff had their meals in the dining room the same time as service users. The inspector discussed the menu with the cook who stated she was happy with the meals being provided. Service users stated the food was very good and they were putting on weight. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 13 Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 Staff have excellent knowledge and understanding of Adult Protection issues which helps protect service users from abuse. The home had a complaint and whistle blowing policy. EVIDENCE: The manager stated the home had a complaint policy. The inspector noted the policy was kept in a Procedures File in the office and also displayed in the front entrance. The manager stated the complaint policy was revised and issued in April 2004. The home had a complaint folder that had no complaint recorded. Visitors stated they were aware of the complaint policy. The inspector had a meeting with staff who stated the home had a complaint policy and a whistle blowing policy that was kept in the office. Staff described appropriately how they would make a complaint or act on a complaint on behalf of another person. The home had regular monthly meetings with service users that offered the opportunity to raise concerns. One service user stated she had ‘nothing to grumble about, the place is nice and clean and the food is very good’. Another service user remarked she used the complaint procedure to make a complaint to the management about her meals being served cold. She remarked she was happy with the outcome. As previously stated, the complaint policy is need of updating. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 15 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 standard(s) 19,20,21,22,23,24,25,26 The standard of the environment within this home is good providing service users with an attractive and homely place to live. However the home must improve the way that ointments and creams are stored and make good the laundry floor. The fabric on some chairs must be replaced to make it nice for service users. EVIDENCE: The inspector noted the home is well maintained with a good standard of décor. On the day of the inspection the home was found to be clean, well ventilated and free from mal odour. The lounge had a television, piano, radio, books, pictures, flowers, and sensory equipment. The dining room was nicely decorated. It had an artificial fireplace, plants, paintings and a large bookcase. The furnishings were of good quality however the fabric on some chairs in the lounge needed to be replaced. The manager stated the fabric was on order. The home was fitted with aids and adaptations and had a stair lift to help service users maintain their independence. The inspector noted the home had an emergency call system. The toilets and bathrooms were clean and hygienic. Lighting in the home was adequate. Bedrooms were found to be clean, well presented and personalised with family photographs, pictures, paintings, Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 16 ornaments and other items of personal interest. One service kept a cage with budgies in her bedroom. The inspector noted that topical applications such as creams and ointments were left unattended in one bedroom. This was discussed with the manager. The laundry had an industrial washing machine and dryer. The inspector noted the surface of the floor was worn and marked. The home had control of infection measures. The inspector observed staff washing their hands regularly and using gloves and aprons as appropriate. The gardens were well maintained with mature shrubs, fruit trees and a vegetable plot. One service user stated when the weather is warm she sits out in the garden to read. She remarked she liked to read books on politics. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28,30 Staff working at the home have the NVQ in Care qualification ensuring they have the skills to adequately support service users. The arrangements at the home ensure staff are appropriately inducted. EVIDENCE: The home has Investors in People Award. The manager stated all staff had the NVQ in Care award. The inspector spoke to staff that confirmed they had NVQ Level 2 and 3 in Care. One staff on duty had NVQ Level 4 and RMA. Certificates were displayed in the hallway. The inspector sampled training files that confirmed staff had induction training. Files had an induction checklist that was dated and signed by the supervisor and supervisee. The areas of training included health and safety, fire safety, food hygiene, moving and handling and first aid. The inspector noted there was an appointed first aider on duty that had the appropriate qualification. One staff stated he would like more training to help him understand the various dosages and side effects of medications. This was discussed with the manager that stated free training is available from the local Primary Care Trust. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,36 The manager is supported well by the senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their role and responsibilities. The arrangements for the supervision of staff are adequate. However, the home must improve the process by which supervision is carried out for staff. EVIDENCE: The home has a qualified and experienced manager that has a nursing qualification, NVQ Level 4 in Management and the RMA. The manager described his management approach as open and leading by example. The inspector had a meeting with staff that stated the management is supportive. They remarked the manager is ‘visible’ and can be contacted at any time for help, advice and support. The staff remarked they had a good relationship with each other and worked as a team. The inspector discussed the management structure of the home. Staff stated they understood the structure and was happy with it. The deputy manager remarked the supervision of staff was Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 19 done every two months. The home operated a diary system for booking supervision. The inspector sampled files and found supervision to be regular and appropriate to the work and job role. The inspector noted the home had no formal arrangements for supervision and discussed this with the manager and deputy manager. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 2 3 3 3 3 3 2 STAFFING Standard No Score 27 x 28 4 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 3 3 x x x 2 x x Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard NMS1 Regulation 4(1)(c) Requirement The registered person must ensure that the Statement of Purpose is updated to state that a complaint can be made to the Commission at any stage should a complainant wish to do so. The registered person must ensure that furnishings are of good quality by replacing the fabric on the chairs in the lounge. The registered person must apply masonary paint to cover all areas of the floor in laundry to ensure it is impermeable. In view of the registration of this home to care for service users with dementia the registered manager is required to risk assess the practice of leaving creams and ointments unattended in service users bedrooms. The registered person must ensure that formal supervision arrangements are put into practice by ensuring staff have named supervisors that are responsible for doing supervision and ensuring records are kept. The registered person must Timescale for action 01.08.05 2. NMS20 23(2)(g) 01.09.05 3. NMS26 13(3) 01.08.05 4. NMS9 13(4)(c) 01.07.05 5. NMS36 18(2)(a) (b)(i) 01.08.05 6. NMS38 37(1)(b) 01.07.05 Page 22 Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 7. NMS7 15(2)(b) ensure that all notifiable incidents are reported to the Commission without delay, this must include cases of MRSA. The registered person must 01.07.05 review the care plan of one service user to ensure that her hearing aid and personal clothing are appropriately managed. 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 Good Practice Recommendations No recommendations were made during this inspection. Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 23 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Dalmuir Home H58_s13621_Dalmuir Home_v220536_180505_stage4.doc Version 1.30 Page 24 - 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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