Inspection on 22/05/06 for Dapplemere

This inspection was carried out on 22nd May 2006.

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

The inspector 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

Dapplemere 20/08/07

Dapplemere 03/01/07

Dapplemere 26/01/06

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Dapplemere Shepherd`s Lane Chorleywood Hertfordshire WD3 5HA Lead Inspector Hazel Wynn Key Unannounced Inspection 22nd May 2006 10:00 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 Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Dapplemere Address Shepherd`s Lane Chorleywood Hertfordshire WD3 5HA 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) 01494 488250 01484 488716 Pressbeau Ltd Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (15), Terminally ill over 65 years of age (7) of places Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 2006 Brief Description of the Service: Dapplemere is a two storey period house to which a modern extension has been added. The extension provides seven nursing places, all in single occupancy bedrooms, whilst the original building offers 15 individual places for elders. There is no lift and the original building is constructed on several levels, which means that residents are required to have a degree of mobility. The home is located in a rural setting a short drive of a junction for the M25 and Chorleywood railway station. The fee range is £600 plus the amount of the Registered Nursing Component granted. Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been drawn up following an unannounced inspection carried out on 22nd May 2006 using available evidence gathered during the inspection including observation, discussion with residents, visitors, care staff and the manager and examination of records maintained in the home. The inspection visit provided an opportunity to speak to the home’s new manager and three staff. A number of residents and two relatives were also spoken with. Medication records, recruitment records, care plans and health and safety records were examined and found to be accurately maintained and up to date. All of the key standards were assessed during this inspection and the overall outcome was positive; work has been scheduled to commence in June (the month following inspection) to improve the environment and accessibility of the environment. Residents were supportive of the home and the way they were treated and the standard of care that they receive. The new manager had been very busy and had audited and introduced new care plans and audited staff training files to ensure all training was updated and where deficits existed she had taken action to provide for this. Recruitment files had also been audited and data added where there were deficits including details of CRB. The recruitment procedure is now robust and the one staff member recruited by the new manager was recruited with robust attention. Staff stated that they were being enabled to acquire and update the training that they need to provide care for the residents. Previous requirements had been met. One requirement was made for the registration of the new manager. What the service does well: What has improved since the last inspection? The new manager has audited the information kept on residents and introduced new care plans with updated information; the care plans meet the National Minimum Standards. All paperwork relating to the home has been updated including staff files (recruitment and training) training schedules include planned updates for all mandatory training and identified specific Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 6 training. The Statement of Purpose and Service Users Guide were updated. Automatic door closures have been fitted and door wedges disposed. 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. Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 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 Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 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 the following standard(s): 3, 4, 5. Standard 6 does not apply to this home. A comprehensive assessment is carried out in order to establish the needs of individual residents prior to the service user moving into the home. The service does not provide intermediate care. The quality outcome in this area is good; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: The manager produced a sample of the new format assessment that has been brought into use quite recently. The assessment was comprehensive and would cover health, social and personal care needs of the service user. The service user information had been updated (statement of purpose and service user guide) this information is provided to residents to assist them to make a choice; copies of this updated information was produced at the inspection. Residents stated that they or their representative are invited to visit the home prior to accepting placement. Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 9 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 - 10 The residents health, personal and social care needs are set out in an individual plan of care and health care needs are fully met. Medication is appropriately managed offering protection to residents. Residents feel that they are treated with respect and that their right to privacy is upheld. The quality outcome in this area is good; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: The individual care plans seen set out within them, the personal and social care needs of the residents for whom they were drawn up and the meeting of the health care needs were being fully met. Medication is managed appropriately; none of the current residents self medicate but protocols were in place for any individual admitted to the home and assessed as able to self medicate. Residents stated that they are treated with dignity and respect and that their privacy is guarded. Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 10 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 - 15 The home provides a range of activities, choices of menu and encourages participation in and by the community. The lifestyle matches the expectations and preferences of the residents. Contact with family, friends and community is actively supported. Residents are supported to exercise choice and control over their lives. The food served is wholesome, balanced and appealing and alternative mealtimes can be arranged. The dining area is pleasant and some residents are served their meal in their own room or if preferred in the lounge area. The quality outcome in this area is good; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: Residents spoken with stated that various activities are available and that their ministers and the clergy from the local churches provide services. The inspector met with some of the visitors to the home on the day of the inspection, and they provided very positive feedback. Residents and relatives meetings are held and recorded on a regular basis. The residents spoken with informed the inspector that they are assisted with making choice and decisions in support of them retaining control over their lives. The inspector observed the serving of the evening meal, which appeared to be of good quality the residents stated that it was. The dining area was comfortable and alternative arrangements were available. One resident preferred to take their evening Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 11 meal in the lounge and the inspector observed that they were being sensitively supported to enjoy their meal. Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 12 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): 16 and 18 The residents, their families and friends can be confident that their complaint will be listened to, taken seriously and acted upon. The residents are protected from abuse. The quality outcome in this area is good; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: No complaints had been received by the organisation. The inspector discussed the ease of complaint making with the manager who pointed out that the complaints procedure is placed next to the signing in book. Four residents stated that if anything isn’t quite right/amiss they only have to mention it and its fixed so there is no need to make a complaint. Two visitors said they had never had to complain. Residents spoken with stated that they have their own solicitors and they are encouraged to use their vote. They are supplied with terms and conditions – sample shown by manager. All charges are invoiced, no service user finances are held by the home. Residents are protected by from abuse by the homes policies and procedures and robust recruitment and staff training. Two staff files were examined at this inspection. There has only been only one staff member recruited since last inspection. All information was available. Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 13 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 & 26 A schedule of work set to commence in June will greatly improve the layout of the home which is currently not suitable to residents who have poor mobility or those who need to use equipment to assist mobility. The environment was clean, fresh and odour free. Given that the new providers have taken swift action and great effort to improve the environment and that work is scheduled to commence following this inspection. The quality outcome in this area is good; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: On the day of the inspection the home was clean fresh, and odour free the proprietors have made a great commitment to improving the environment (both from a safety aspect and aesthetic aspect) since taking over the business and have made every effort to ensure the safety of the residents. Planning permission for an extension to the listed building was not granted and the proprietor has reverted to a second plan to add a lift to the home and level floors. Following the building works, redecoration and carpeting is scheduled; in the meantime, they have restricted the number of residents in the upstairs Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 14 of the home to three. Door guards had been fitted since the last inspection and all door wedges disposed. Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 15 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): 27 - 30 There are adequate numbers of skilled staff to meet the needs of the residents. Residents are in safe hands at all times and they protected by the home’s recruitment policies and practices. The quality outcome in this area is good; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: There were adequate staff on duty and the rota provided evidence that the home maintains adequate staffing levels. Some of the staff have nurse qualifications and are registered and many of the careworkers have NVQ’s. The remainder are planning to do so or were in the process of achieving these. Moving and handling training had been completed/updated by all staff. Policies and procedures were in place to protect service users. Under the new provider and manager recruitment is robust. An audit of training needs had been carried out; all mandatory training needs had been provided and additional courses attended by staff or planned for. The training audit was produced during the fieldwork. 12 staff had attended external abuse awareness training (externally) and 6 more planning to attend an external course, in house training had been provided to all staff through policies and procedures in vulnerable adult protection. The new provider has been obtaining missing information from the files of staff who transferred to the employment of the new owner. The audit of staff files was seen during the inspection. All staff have had a CRB and POVA check carried out. Two staff files were examined and these contained all necessary information – only one staff member recruited since the last inspection and the recruitment had been robust. Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 16 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, 33, 35 and 38 The residents are benefiting from the ethos, leadership and management approach of the proactive manager and proprietor. (The manager must apply to be registered with the CSCI and the process was commencing on the day of the inspection).The home is run in the best interests of the residents. The residents’ financial interests are safeguarded. The health, safety and welfare of service users and staff are promoted and protected. The overall quality outcome in this area is adequate. A judgement of good cannot be made due to the fact that the manager is not yet registered. EVIDENCE: The manger is fairly new to the home and had been extremely busy auditing the systems and records in place and prioritising her plans for improvement and the way forward; she was previously the registered manager of another home in Hertfordshire and has proven herself over a long period of time to be a fit manager, having vast experience. The home must have a registered Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 17 manager and an application and an application for registration at Dapplemere must be received as a matter of priority. The manager in meeting with the regulation inspector presented as very approachable, committed and professional. As stated earlier in this report the manager has audited residents and staff files and introduced new systems that are robust and comprehensive (see under Choice of Home, Personal Care and staffing sections). Fire safety records were up to date and fire safety equipment had been kept serviced. Residents and relatives meetings are held on a very regular basis to ensure that their views are heard and that the home is run in the residents’ best interests. The home does not deal with residents’ finances all charges and extras are invoiced for payment. Policies, procedures, staff training, risk assessments and protocols were in place to safeguard the health, safety and welfare of service users and staff. Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 18 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 X X 3 Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 19 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 OP31 Regulation 8(1) Requirement A fit person must be registered to manage the home. The proprietor stated that the registration application process would commence on the day of the inspection. An application to appoint a registered manager must be received by no later than 30/06/06. Timescale for action 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Dapplemere DS0000064417.V289848.R01.S.doc Version 5.1 Page 21 - 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. 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