Inspection on 03/07/07 for Darlington Manor Residential Care Home

This inspection was carried out on 3rd July 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

Darlington Manor Residential... 28/06/06

Darlington Manor Residential... 09/11/05

Darlington Manor Residential... 06/10/04

Darlington Manor Residential... 12/05/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Darlington Manor Residential Care Home Darlington Manor 70 Falmer Road Darlington Durham DL1 4AZ Lead Inspector Jean Pegg Unannounced Inspection 3rd July 2007 09:30 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 Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Darlington Manor Residential Care Home Address Darlington Manor 70 Falmer Road Darlington Durham DL1 4AZ 01325 361166 01325 487600 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) Manor Care Home Group Samantha Louise Gibson Care Home 63 Category(ies) of Dementia - over 65 years of age (31), Old age, registration, with number not falling within any other category (32) of places Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 6 people over the age of 55 years may be accommodated in the home. Residency may be in either the general residential unit or the dementia care unit. 28th June 2006 Date of last inspection Brief Description of the Service: Darlington Manor provides residential accommodation for up to sixty-three older people including thirty-two people within the dementia care unit. The home is in a residential area of Darlington and is situated just outside of the town centre. The home is a two-storey building that overlooks Eastbourne Park. The home stands in it’s own private gardens with an ornamental fountain in front of the front entrance porch. The gardens are very well kept. There is also adequate car parking available for visitors. Inside, the home has fifty-eight single bedrooms and five double bedrooms. Twenty-seven bedrooms have full en-suite facilities; the remaining bedrooms have private wash hand basins. The home has two passenger lifts, five lounge areas including a lounge for those that choose to smoke and two dining rooms. A bus stop and the railway station are within walking distance of the home. Darlington Manor aims to be part of the local community and works hard to get involved in lots of community activities. The home also has a variety of pets that live there. The home charges the following fees. General residential fees are £366 and Dementia care fees are £371 per week. These fees include food, accommodation laundry and staff on duty twenty-four hours a day. Additional charges are made for some entertainments, hairdressing and chiropody, newspapers and other personal items. Current charges and what they include should always be checked with the manager prior to admission to the home Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days and lasted for twelve hours. To help us with this inspection we sent survey forms to some of the people who live at the home, their relatives and care managers. We also spent time talking to some of the people who live and work at the home. On one of the days we spent time with a group of people who were taking part in a game of musical bingo. We got some other information about the home by looking at some of the records kept at the home and by auditing some of the processes that they follow. This helped us to understand whether or not they were doing what they said they would do. Of the surveys that we sent out we received eight back from the people who live at the home, six relative surveys and one care manager survey. The results of these surveys will be used in parts of this report. What the service does well: Contracts that give basic information about what people who live at the home can expect to receive for the fee they pay are provided to the people who live there. Either the person who lives at the home or their relative has signed the contract. One person told us “I could not remember signing one (contract) but a member of staff showed me and I had signed it.” Staff from the home visit people and complete pre admission assessments before any admission to the home is agreed. This helps the people involved to decide whether or not the home is able to meet the individual persons’ needs. We were told “I looked around three homes before I settled here. And after looking at all three I decided this home was for me.” Care plans are in place for the people who live at the home. These care plans are quite detailed and in most cases they have been agreed with either the person living at the home or their relative. Individual health needs are met by making sure that the people living at the home have access to community based health care professionals. The way that medication is managed within the home is satisfactory and privacy and dignity are respected “I am being cared for and looked after. The carers are good to me. My needs are met.” The care staff that work in the home try to provide the people who live in the home with a lifestyle that they will enjoy. Activities to suit a range of different tastes are provided including community based activities such as going to the shops or luncheon clubs. The people who live in the home are encouraged to make choices and decisions in their lives. Meals are provided that suit most people and alternatives are offered when needed. Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 6 Complaints are listened and responded to and procedures and work practices are in place to protect vulnerable adults from harm or abuse. The home remains suitable for its purpose as a residential home for older people and is reasonably well maintained. The home is cleaned regularly and is homely and lived in. One person said “Very spotless, the girls who clean are marvellous. Cleaners should be given a medal.” Staff are offered training to do their job properly and recruitment practices are good in that all of the proper checks are carried out before people are allowed to start working at the home. The home has a registered manager who has worked in the care environment for a long time. There are lots of systems used to make sure the home is providing a good quality of care. This includes using annual surveys with relatives and other health care professionals. What has improved since the last inspection? What they could do better: The written information available about the home should be available in different formats that can be understood by people who may have sight or reading difficulties. The attitude of some staff could be improved. As one person told us some staff were “not as patient” as others. The complaints procedure should be produced in different formats to make them easier for people to understand and use. A record of concerns and complaints should be kept so that trends can be monitored in the home and improvements made. Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 7 The home should think about replacing some of the baths that have surface damage on them to prevent any problems of infection. Staffing levels within the home are generally satisfactory however; there are occasions when this could be improved to ensure that people living at the home are not disadvantaged in any way. Generally the home does encourage safe working practices but there are some areas where the manager needs to take specialist advice. For example the appropriateness and risk assessment of the type of window restrictors used in the home and the level and type of health and safety training that the home should be providing for staff. 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. Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 8 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 Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 &3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although people told us that they had been given information about the home, the written information available is not in a format suitable for people who may have sight problems or any other reading difficulty. Contracts are provided to the people who live there and either the person who lives at the home or their relative has signed these. Staff from the home complete pre admission assessments before any admission to the home is agreed. This enables the people involved to decide whether or not the home is able to meet the individual persons’ needs. EVIDENCE: There have been no changes made to the content or design of information available for service users since the last inspection. The home has recognised that it needs to do more work on the Service Users’ Guide to make it more user friendly, interesting and easier for people to understand. We asked people Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 10 the question ‘ Did you receive enough information about this home before you moved in so you could decide if it was the right place for you?’ six people said ‘yes’ and two said ‘no.’ Some of the comments made included “I looked around three homes before I settled here. After looking at all three I decided this home was for me.” And “I was shown two homes only and preferred this one.” None of the comments made were about the written information that had been given out about the home. All eight people who returned survey forms said that they had received a written contract. One person told us “I could not remember signing one but a member of staff showed me and I had signed it.” Of the four files that we looked at one did not have any evidence of a signed contract with the person living at the home. The manager was aware of this before we told her and was in the process of putting things right. Three files were checked for evidence of pre admission assessments, of these, two showed evidence of pre admission assessments having been completed by staff from the home and copies of care manager assessments were in place. The manager said that possible admissions to the home are always discussed with the senior care staff and deputies to agree whether or not the home is able to meet individual persons’ care needs. Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9&10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are in place for the people who live at the home. These care plans are quite detailed and in most cases have been agreed with either the person living at the home or their relative. Health needs are met by ensuring people have access to community based health care professionals. The way that medication is managed within the home is generally satisfactory and privacy and dignity are respected, however, the attitude of some staff could be improved. EVIDENCE: Four care plans were checked. The manager showed an example of a care plan that was written to the standard that she was working towards achieving with every person. She acknowledged that not all care plans were up to this standard. The care plans seen did vary in the standard of recording used, however, there was evidence that they had been audited by senior staff and Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 12 notes were left for the staff responsible for maintaining the files detailing what the short comings were. The standard of care plan recording that the home is working towards achieving is very good. Of the files seen there was evidence of lots of good information being collected and recorded. For example the care plans included things about the person’s health care needs, social needs and preferences and financial needs and arrangements. It was clear that each plan had been written to meet that person’s individual needs. There was also evidence of either the person living at the home and/or their relatives having given their agreement to the written care plans and risk assessments. The records showed evidence of other health care professionals being involved in the care of the people who live at the home. For example General Practitioner (GP) visits, eye tests and weight charts etc. The manager was also introducing GP visit sheets that would be completed by the GPs during their visits. This would help to avoid any confusion or misunderstanding about instructions being given about people’s individual care following a visit from the doctor. We also saw the district nursing team talking to care staff and passing on information about the people they had visited in the home that day. One relative told us “I visit my mum most days. If mum is not well or needs the doctor they always phone me and let me know.” As part of a local initiative the community pharmacist had visited the home to audit the way medicines were managed in the home. The manager said that she thought that this had been a positive experience and had acted on the advice they had been given. We checked the medication records of four people and found that in general the records were satisfactory. There were some problems identified with ensuring that the records of prescribed medication kept in the care plan were up to date and matched the Medicine Administration Records used on a daily basis. The manager or deputy manager audit the medication records each month to make sure that staff are following procedures correctly. By doing this any problems can be quickly and easily dealt with. The manager told us that they were awaiting the delivery of a new fridge to be used for medicines. When we asked staff to give us examples of how privacy and dignity are respected in the home, they were able to do this. Their comments included examples of the practical things they would do and the importance of how people are spoken to. The comments made by people who live at the home on the surveys that were sent back were mixed. Some people were not happy about the attitude of some staff saying that some were “not as patient” as others. However, the majority of comments received were positive for example “I am being cared for and looked after. The carers are good to me. My needs are met.” And “The staff very kind and caring.” The induction programme followed does include guidance on the homes philosophy of care and respectful behaviour. We also know that the management of the home does not tolerate disrespectful behaviour towards people once they know about it. Generally the comments we received were more positive than negative about the home. Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14&15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home try to provide the people who live in the home with a lifestyle that is acceptable to them. Activities to suit a range of tastes are provided including community based activities. People are encouraged to make choices and decisions in their lives. Meals are provided that suit most people and alternatives are offered when needed. EVIDENCE: The home has three staff who provide a range of different activities for people to take part in. These staff work on a part time basis. There were lots of photographs on display in the home and in individual files showing people taking part in activities. As part of the information gathering that takes place when someone is admitted to the home, staff try to find out what social activities people prefer including preferences in food and drink. The activities coordinators hold regular resident meetings that discuss things such as the planned programme of activities and menu changes. In response to suggestions made by the people who live at the home, the activities staff work Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 14 some weekends and evenings. While we were at the home we joined a group of people who were playing musical bingo and we spoke to another group of people who were looking forward to the musical movement session planned for the afternoon. These are some of the things that the people living at the home told us “I find that at first I always say no (to activities). But with persuasion I do take part. Afterwards I am glad I did join in. I find I become more popular by joining in.” “I enjoy arts and crafts, entertaining there are the music evenings and I like to occupy myself with reading.” And “I am registered blind so can not join in all activities e.g. bingo. But I enjoy the activities I can join in very much.” During our visit we noticed a lot of people visiting the home and a large number of the people who live at the home were also going out to the shops or for a walk in the garden or park. On our survey to relatives we asked the question ‘What does the home do well’ we were told “Happiness and the feeling that each resident is special. There are activities for those wishing to take part in social outings, birthday parties for residents and families are welcome to attend.” The home also provides newsletters to relatives including feedback from the annual quality assurance survey that relatives take part in. As far as possible the people living at the home are encouraged to make choices and be in control of their lives. The care plans that we saw were supportive of people retaining their independence in health, social and financial matters. One constraint that we did notice on the first day that we visited was that one person was unable to exercise complete choice in what they wanted to do. The bedrooms that we saw were all different in that people had bought in lots of their own possessions. Some rooms were very tidy and others were very lived in, again showing the different preferences and personalities of the people who live there. The chef is devising a new menu and there are plans to have a menu placed on each dining table and in each bedroom. The proposed menu is to go before the residents committee for approval. We were told that special diets are catered for. The home keeps a record of the meals taken each day and any alterations that are made to the menu. The home used to ask for comments from people following each meal but this practice seems to have stopped which is disappointing as it did give an indication of what people thought about the food. Weights are monitored. The dining rooms are pleasant in that time has been taken to make them feel homely. For example there is a collection of teapot ornaments on display in one dining room and pictures in the other. The floor covering is looking old and in need of replacement. The home has recently been awarded four stars for Hygiene from the local Environmental Health Department for good standards of hygiene. This is what some people said about the food in the home “Bigger portions would be nice.” “I especially enjoy Sunday lunch.” And “I think the home does it’s best with the ingredients it is allowed.” We saw that the home does try to accommodate individual preferences. We noticed that different variations of the main meal were offered Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 15 as well as alternatives to meet individual requests for example boiled eggs, soup, chips and omelettes. One member of staff has the responsibility of making sure that people have their weights monitored each month. Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are listened and responded to and procedures and work practices are in place to protect vulnerable adults. EVIDENCE: In the main entrance foyer there is a file that contains numerous cards and compliment forms. These cards and forms have been completed by relatives; care managers, nursing services staff, other health care practitioners and the people who live there. Most of the comments made were in relation to the care provided to the people who live there including the support given by staff to relatives, support given to students placed there and general comments about the professionalism of staff. Although there were complaint forms available for people to complete, from talking to the manager, it would seem that people tend to voice their concerns rather than make them in writing, she also said that quite often people said that they did not wish their concerns to be recorded as a formal complaint. We had a discussion as to how the areas of concern that people had could be recorded in a way that would enable trends to be monitored. The complaints procedure was on display in the entrance foyer. Copies of the complaints procedure have also been sent to relatives in previous newsletters. The complaints and compliments forms have been changed. Some are on yellow paper with larger print , which make them easier Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 17 to read, and some have pictures on. The complaints procedure also needs to have similar improvements made to it. For example easy read versions and larger print. We asked the people who live at the home if they knew who to speak to if they were unhappy and six of the eight said that they did. “I always ask for the person in charge.” And “The manager is the person I need to speak to.” We asked relatives if they knew how to make a complaint and all six said ‘yes’ adding “I would contact social services.” We also asked relatives if the care service responded appropriately to any concerns raised about their care. Five said ‘always’ and one said ‘usually’. One person added, “There have been some concerns about the drugs my relative was prescribed and the staff have always done their best to resolve the problems.” The staff spoken to were familiar with the actions to take should they suspect that the people living at the home were being abused in any way. The numbers for contacting the social services department and the police were on display in the manager’s office. The manager has demonstrated in the past that she does know how to make adult protection referrals to the social services department and the Protection of Vulnerable Adults register. Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 &26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home remains suitable for its purpose and is reasonably well maintained. The home is cleaned regularly and is homely and lived in. EVIDENCE: The manager confirmed that a capital grant from the local authority had been given to the home. This grant is to be used to decorate and upgrade the bedrooms, fit the bathrooms with non-slip flooring and showers, improve the garden areas and purchase activity equipment and a computer with internet access for the people who live there to use. The manager told us that all but one corridor carpet had been renewed and that the remaining corridor was due to be fitted soon. As we walked around we noticed that each person’s photograph was hung beside his or her bedroom door, this is sometimes very Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 19 helpful for people to recognise where their bedrooms are. There was some evidence of some new furniture in the home and the manager spoke about plans to re decorate the upstairs lounge in the EMI unit. We noticed that in some of the bathrooms that the surface of the baths were chipped and worn. A new ceiling hoist had been fitted in one of the bathrooms to enable individual needs to be met. The housekeeper completes room audits on a regular basis and these completed audits were seen. The external grounds and gardens were very colourful and well maintained The home has been provisionally awarded the Tees Valley Food Hygiene Award of four stars for very good standards of hygiene. The housekeeping staff are also encouraged to work towards the achievement of National Vocational Qualifications. During our visit the home was clean but still had a lived in feeling to it. Some offensive odours were evident but these were mainly localised problems that the manager and housekeeping staff were trying to manage. The home was very tidy and clean during our visit. One person made the comment that there was “A lack of towels in the bathroom and the bin in the bathroom containing pads needs changing regularly.” We asked the people who live in the home ‘Is the home fresh and clean?’ six said always and two said usually. The comments made included “Very spotless, the girls who clean are marvellous. Cleaners should be given a medal.” Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels within the home are generally satisfactory however; there are occasions when this could be improved to ensure that people living at the home are not disadvantaged. Training is supported in the home and recruitment practices are good in that all of the proper checks are carried out before people are allowed to start working at the home. EVIDENCE: The manager provided evidence to show that the staff employed at the home were diverse in age, gender, ethnic origin and disability however, at present the care staff are all female although male staff have been employed in the past. Generally there are eight staff on duty for the fifty four people who currently live at the home. On the day of our visit one person was off sick who should have been working in the dementia care unit. It was noticeable that this put the remaining staff under pressure and we expressed our concerns about the people in the dementia care unit having to spend their time downstairs as there were not enough staff to provide adequate supervision on both floors of the unit. The following comments provided by the people who live at the home and their relatives confirmed our thoughts. For example “The staff are not always very quick to assist as they are sometimes busy with other people but Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 21 usually come to see me.” “Sometimes have to wait if they are really busy but I understand that.” And “ Could do with more staff as at times they are very stretched.” The care staff are supported by housekeeping, catering, maintenance and managerial staff. The home continues to maintain a good standard of trained staff. All care staff have either completed a National Vocational Qualification (NVQ) 2 in Care or are currently working towards achieving the award. Some staff have completed NVQ 3 in Care and some are waiting to start NVQ 4 in Care. Four staff files were checked to see if all the proper pre employment checks had been carried out. All of the files were in order. Staff confirmed that they received training including Dementia Care, Safe Handling of Medication, Infection Control and Nutrition. Some domestic staff are also working towards achieving a qualification in Health and Social Care. The manager said that they were planning to provide more in depth training in ‘Nutrition for the Elderly’ and ‘Dementia Care’. These are some of the things that staff told us about their training. “Brilliant – learning all the time, just finished infection control.” “Brilliant induction – introduced to everyone I was with someone all the time.” and “Pretty good. Some things are interesting. Some are boring. Dementia was good, NVQ was O.K. Infection Control, First Aid, Fire and Food Hygiene.” We asked relatives ‘ Do the care staff have the right skills and experience to look after people properly?’ Five said ‘always’ one said ‘usually’. One person added “As far as my relative is concerned, Yes. The staff with whom I have had contact seem to know how to deal in the right way with my relative who suffered from dementia. They show patience and understanding in sometimes difficult situations.” Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35&38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a registered manager who has worked in the care environment for a long time. There are lots of systems used to monitor the quality of care provided including annual surveys with relatives and other professionals. There have been improvements made to the management of finances in the home. Generally the home promotes safe working practices but there are some areas concerning risk assessments and training that the home needs to take specialist advice about. Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 23 EVIDENCE: The manager became registered in February 2006. She has worked at the home for a long time before taking up the post as manager. She has completed the registered managers award and was also awarded student of the year in 2006. She is hoping to commence the National Vocational Qualification level 4 in Care in September 2007. The manager has a clear job description that gives her responsibility for the day-to-day management of the home. Decisions concerning major expenditure within the home are taken at head office level. The staff we spoke to were positive about the management of the home. One said about the manager “Any worries or problems she is approachable and in control.” An Annual Development Plan is in place and this is monitored by the manger each month. Staff meetings and resident meetings are held and records are kept. A suggestion box is in place and we were shown the monthly summary of suggestions and what actions were taken to respond to those suggestions. We were given the results of the last stakeholder survey and the letter that was sent out to relatives detailing what actions were being taken as a result of the comments made. The manager completes a series of monthly audits and these audits cover staff, care plans, medication, quality assurance checks and environmental issues. The area manager visits regularly on behalf of the registered provider and regulation 26 reports are completed. The home did not have copies of all of these reports for us to see. The housekeeper and the manager complete room audits on a sample of rooms each week. These audits can be linked to ordering of replacement furniture and maintenance issues. Each person has a financial care plan in place. A new system to help manage service user finances has been introduced. The people who live at the home are encouraged to open individual savings accounts so that interest can be earned on their money. An audit of pocket monies was undertaken and was found to be satisfactory. We discussed the use of two signatures being used when signing money out to people and also the benefits of regular auditing of service users finances. A representative from head office audits the petty cash. As we walked around the building we noticed that fire extinguisher and mechanical hoist service stickers were up to date. Weekly water checks were being carried out and an electrical wiring check has been completed recently and we were told that the home was awaiting the final report. The inspection of water installations was completed in May 2007 and was thought to be satisfactory. The gas safety inspection work that was required was completed in August 2006. A Fire officer has been out and the home is awaiting his return to check that the work that was required has been completed. Nurse call bells were serviced in April 2006. Accident analysis reports were seen with remedial actions noted. There were two areas that we expressed concern about during our visit. One was that the home have recently moved over to Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 24 using videos to train staff in the following topics Fire, First Aid and Moving and Handling. Although videos are useful they should not replace practical training in these topics. Secondly we raised some concerns about the type of window restrictors being used in the home and advised the manager to take advice about their appropriateness and risk assessments that may be needed. Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 25 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 2 3 3 X X 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 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 27 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 OP1 Good Practice Recommendations It is recommended that the manager continues to develop the format and style of service user’s guide so that it is contains relevant up to date information in a format that is interesting and easy to understand. (Recommendation made 28/06/06) The complaints procedure should be produced in different formats that take into account the range of service user physical and cognitive abilities. (Recommendation made 28/06/06) The home should consider replacing some of the baths that have surface damage on them to prevent any problems of infection. The staffing levels at the home should be constantly reviewed and adjusted to ensure that people’s needs are met without unnecessary delays. Staffing levels should also ensure that people’s rights to autonomy and choice are not restricted. The manager should work towards achieving the National Vocational Qualification Level 4 in Care. The registered provider should ensure that copies of the regulation 26 reports are sent to the registered manager of the home. Two signatures rather then one should be used to record and confirm that money has been given out of individual pocket money accounts. Individual pocket money accounts should be audited on a regular basis. The manager should seek specialist advice as to the correct level and method of training that should be provided to staff in Fire Safety, First Aid and Moving and Handling. The manager should seek specialist advice about the appropriateness and risk assessment of the window restrictors used in the home. 2. OP18 3. 4. OP19 OP27 5. 6. 7. 8. 9. OP31 OP33 OP35 OP35 OP38 10. OP38 Darlington Manor Residential Care Home DS0000000806.V343373.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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