Inspection on 22/12/08 for Darley Dale

This inspection was carried out on 22nd December 2008.

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

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

Darley Dale 18/12/07

Darley Dale 26/04/06

Darley Dale 21/01/06

Darley Dale 31/05/05

Darley Dale 18/10/04

Darley Dale 08/06/04

Darley Dale 08/12/03

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Belma

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Darley Dale 35 Libertus Road Cheltenham Glos GL51 7EN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Adam Parker     Date: 2 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Darley Dale 35 Libertus Road Cheltenham Glos GL51 7EN 01242513389 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Mary Rebekah O`Connor Name of registered manager (if applicable) Mr John Francis O`Connor Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Darley Dale is a small family run care home on the west side of Cheltenham town; it is situated close to local amenities, bus services and the main railway station. The house is Victorian and has been extended to provide accommodation for thirteen older people. The ground floor has a large dining/lounge area with the kitchen adjacent to it. Laundry facilities are situated outside in the small courtyard. Accommodation is provided in single rooms, eight of which have en-suite facilities. There are three communal bathrooms that provide assisted bathing. Bedrooms are situated on the ground and first floor. There is a shaft lift for easy access between floors. The home has a secluded rear garden where people can sit, and a small parking area near the entrance at the side of the home. The home provides copies of the Service User Guide and the latest CSCI inspection report for people to see before admission. The weekly fees charged by the home are the same as the current Community Adult Care Directorates (Social Services) level for older people, there are currently no extra Care Homes for Older People Page 4 of 23 0 Over 65 13 care home 13 Brief description of the care home payments for care or `top ups? required. The manager will provide the information on request. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was carried out on one day in December 2008. The registered manager of the home was present for the inspection visit that consisted of a tour of the premises and examination of residents care files. In addition staff training was looked at as well as medication storage and administration and documents relating to the management and safe running of the home. Four residents were spoken to during the inspection visit as well as one member of staff. An Annual Quality Assurance Assessment (AQAA) form was sent to the home for completion prior to the inspection visit. This was completed satisfactorily and gave us the information we asked for. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the Care Homes for Older People Page 6 of 23 views and experiences of people using the service. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes admission procedure ensures that residents are admitted to the home on the basis of a full assessment of their needs, so that they can receive the care that they require. Evidence: Two pre-admission assessments were looked at that had been completed by the home. This had been carried out when residents had initially visited the home. Generally the local authority complete a detailed assessment and care plan for the residents they are funding before admission. The manager stated that health care professionals are contacted by the home for any further information when required. There was evidence of this in relation to one resident. The home does not provide intermediate care and so standard 6 does not apply. Care Homes for Older People Page 10 of 23 Care Homes for Older People Page 11 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home works well to meet residents health and personal care needs whilst upholding their privacy and dignity. Evidence: Care plans were brief but specific to residents individual needs. In addition care plans had been written for any potential needs that residents may have at night. This is particularly important as there are no waking night staff. Care plan reviews had taken place although these were not on a monthly basis. Risk assessments had been completed for dietary requirements and moving and handling. Following a dietary risk assessment for one resident a nutritional care plan had been completed. Residents are weighed on a weekly basis and during bathing a check is made on their skin condition in relation to managing any potential pressure area problems. The homes AQAA document described how any pressure area problems would be reported to the district nurse or General practitioner (GP). In addition it also reported that in November 2008 there were no residents with any pressure area Care Homes for Older People Page 12 of 23 Evidence: problems. There was recorded evidence of residents receiving input for health needs from health care professionals such as chiropodists and an optician and a dentist. One resident had received a visit from a district nurse for an influenza vaccine. One resident was receiving input from a Community Psychiatric Nurse (CPN). The home should check if arrangements are in place under the care programme approach and if so request a copy of related documents and request involvement in any future review meetings. Medication storage administration and recording was looked at. Medication storage temperates had not been monitored and this should take place with a record kept to ensure that residents medication is being stored at the correct temperature. There were no gaps seen in the recording of administration on the Medication Administration Records (MAR). Some hand written directions had been made on the MAR although these had not been signed by the staff member making the entry or checked by another staff member. Audits of medication and administration charts had been carried out and recorded. All of the residents spoken to during the inspection visit confirmed that they had their privacy respected and that staff knock on the door before entering their room. Care Homes for Older People Page 13 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a choice of activities, good social contact and a selection of meals planned through consultation about their preferences. Evidence: In general the home does not organise formal activities and residents pursue their own interests through relatives or contacts in the local community such as churches. Some residents keep close ties with family with some planning to go out of the home for short stays with family members over Christmas. It was reported that an outside entertainer no longer visits the home as residents didnt want this. A mobile library visits the home every six weeks and this service was clearly enjoyed by one resident spoken to. Information about advocacy services is available in the home. Residents are able to personalise their individual rooms with a number of items including furniture. Meals are chosen by the residents on a daily basis and a record of meals provided is kept. Residents described the meals as very good and tasty. A record is kept of Care Homes for Older People Page 14 of 23 Evidence: individual likes and dislikes with regard to meals and one resident stated that the staff knew what meals she liked. At the time of the inspection visit there were no special diets being provided for residents in the home. Care Homes for Older People Page 15 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available if any resident or their representative should wish to make a complaint and the homes approach to training staff should ensure that residents are protected from abuse. Evidence: It was reported that all residents had been given a copy of the complaints procedure. The example looked at included the most recent contact details for the Commission. One resident described how she would take any complaint to the manager of the home or to social services. Since the previous inspection all staff have received training in adult protection. The registered manger was aware of the role of the local authority adult protection team and information about this was available in the home. There have been no incidents of abuse reported in the home. Training was being planned in the Mental Capacity Act 2005 as well as deprivation of liberty safeguards. Care Homes for Older People Page 16 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have the benefit of living in a well maintained and clean, environment. Evidence: A tour of the premises was undertaken. All areas of the home inspected were found to be clean, well maintained and decorated and no malodours were detected. One bathroom had recently been refurbished and work was planned to improve another bathroom. One resident spoken to gave positive views about the refurbishment of the bathrooms. Residents rooms were comfortable and contained various degrees of personalisation. A modification had been made to the ensuite facilities in one room at the request of the resident. The resident was spoken to and was happy with the improvement. The laundry had washable floor and wall surfaces and arrangements for hand washing. Care Homes for Older People Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are cared for by a well trained and consistent staff group Evidence: Staffing in the home is arranged so that on a typical weekday there are two staff on the morning shift and two on the afternoon shift. At night, two staff sleep in and can be alerted by call bell. As well as care, staff carry out cleaning and cooking. Over half of the staff employed had achieved a National Vocational Qualification (NVQ) at level two or above. additional training had been carried out in number of areas relevant to the needs of the residents such as care of the ageing skin and dementia awareness which was relevant to one resident who had some memory problems. There had been no staff recruited since the previous inspection. However possible recruitment was being looked into and in discussion the registered manager demonstrated that he was aware of the required pre-employment checks. Any new staff employed may need induction training to the national Common Induction Standards for social care and the home should give consideration to this. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home that is managed in their interests with some actions carried out to ensure their safety and the quality of the service. Evidence: The registered manager has a background in social care and has achieved the registered managers award at NVQ level 4 as well as attending other training provided to the staff team. Quality assurance in the home consists of survey forms sent to residents relatives and visiting health and social care professionals. The registered manager reported that any negative comments would be followed up. In addition informal residents meetings are held daily where discussions take place and checks are made if residents are happy with the service. Minutes had been recorded for some residents meetings to which relatives had also been invited. Residents satisfaction with meals had been discussed as well as suggestions for new meals. One resident had requested some board games Care Homes for Older People Page 19 of 23 Evidence: to play in the home and this had been acted upon. The home does not look after any money or valuables on behalf of residents. However secure facilities can be made available in individual residents rooms if requested. Staff have received training in safe working practices in the areas of fire safety, infection control, food safety, moving and handling and first aid. Portable electrical appliances had been checked during 2008 and the electrical wiring was due for a check in January 2009. The central heating was overdue for an annual service although the registered manager reported that this was being arranged. The lift and a hoist had been serviced in October 2009. No risk assessment was in place for Legionella and this should be completed to determine if there is any risk to residents. Guidelines published by the Health and Safety Executive should be followed. In addition no checks had been recorded on the water temperatures from hot water outlets. This should be carried out in the interests of residents safety and comfort. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The home should check if Care Programme Approach arrangements are in place for any residents receiving input from mental health services and if so request any relevant documentation and involvement in any future review meetings The temperature in the medication storage cupboard should be monitored and recorded to check that residents medication is being kept at the correct temperature. Handwritten directions on medication administration sheets should be signed and dated by the person making the entry and checked and signed by another member of staff. Induction training in line with the Common Induction Standards should be considered for any new staff employed. Checks should be made and recorded on the temperature of water from hot water outlets in the interests of residents safety and comfort. A risk assessment following Health and Safety Executive guidelines should be completed regarding any risk to residents from Legionella. 2 9 3 9 4 30 5 38 6 38 Care Homes for Older People Page 22 of 23 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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!