Inspection on 22/11/05 for Darsdale

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Darsdale 12/02/09

Darsdale 06/09/06

Darsdale 13/06/05

Darsdale 03/03/05

Darsdale 17/08/04

Darsdale 16/03/04

Similar services:

Applegarth

Thornham Grove

Hunter`s Lodge

Conifer Lodge

Manor Court

92 Black Prince Avenue

Agnes House

The Manor House

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

CARE HOMES FOR OLDER PEOPLE Darsdale Chelveston Road Raunds Northants NN9 6DA Lead Inspector Irene Miller Unannounced Inspection 22nd November 2005 13:30 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 Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 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. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Darsdale Address Chelveston Road Raunds Northants NN9 6DA 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) 01933 622457 01933 389399 Northamptonshire Association for the Blind Mrs Valerie Margaret Grant Care Home 30 Category(ies) of Sensory Impairment over 65 years of age (30) registration, with number of places Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user identified in a letter dated 16th June 2004 (subject of variation application Number V000014542) with a sensory impairment and under the age of 65 years of age may be accommodated in the home. 13th June 2005 Date of last inspection Brief Description of the Service: Darsdale is a residential care home providing personal care for 30 older people over the age of 65 years. The home is registered for service users who have been diagnosed with a sensory impairment.Darsdal is owned by Northamptonshire Association for the Blind which is a charitable organisation.The home is set in large and pleasant grounds on the outskirts of the small town of Raunds.There are bedrooms on both the ground and first floors of the building. A lift provides access to the first floor bedrooms. All Residents have accommodation provided in single rooms and twenty four of the rooms have en-suite toilets. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The primary method of inspection used was ‘case tracking’ which involved tracking the care of three residents, through a review of their records and discussion with them where possible. Observation of care practices, discussion with the registered manager, residents, staff and a limited tour of the building. The inspection took place over a period of five hours following one hours preparation, which included reviewing previous inspection reports and other documentation relating to the home. What the service does well: Information is available to enable service users to make an informed choice before being admitted to the home. The care plans and risk assessments contain sufficient information on the range of the health and personal care required by the residents. Visiting times are flexible, visitors are welcomed into the home by staff and there is good relationships forged with visiting families. Residents said that they are well cared for and felt safe living at the home, during a limited tour of the building there were residents spending time within their rooms through personal choice, listening to music and talking books. Individual choice is exercised in where residents choose were to take their meals The home has introduced a staff no smoking policy to ensure a healthy environment for residents. The home has undergone extensive redecoration and refurbishment to include introducing colour coded handrails to corridors to aid in orientating residents around the building and upgrades to the bathrooms and toilets. The bathrooms and lavatories are clean and bright, with grab rails in strong contrasting colours to the bathroom furniture, to make them more visible. There is tactile signage to identify bathrooms, toilets and the lift. The home has achieved the target set by the national minimum care standards act 2000 that at least 50 of the staff are trained to National Vocational Qualification level 2 by 2005. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 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 Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 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): 1,2,3,4 & 5 Standard 6 is not applicable. Information is available to ensure that the home can meet the needs of the residents and enable service users to make an informed choice before being admitted to the home. EVIDENCE: Full pre assessments are conducted for each prospective resident to ensure that the home can fully meet their needs, other relevant assessments are carried out by the local authority. Written contracts of the terms and conditions of residency are in place that are available on tape or brail if required. The home is flexible with the admission procedure; prospective residents are encouraged to visit the home prior to moving in, however the home recognises that for some people this may be traumatic, therefore each admission is tailored to the individuals needs. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 9 A sample check of the assessments alongside the care plans confirmed that relevant information had been transferred to the care plans to inform staff as to the residents needs Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 The care plans and risk assessments contain sufficient information on the range of the health and personal care required by the residents. EVIDENCE: Moving and handling assessments, daily routines, dietary preferences and medical history is contained within the care plans for staff to follow. The residents preferred methods of communication are outlined within the care plans and risk assessments are in place for residents who are at risk of falling, due to disorientation and memory and sensory losses. For residents who are identified at risk of developing pressure area ulcers, there were instructions for staff to observe pressure areas, however when speaking to staff they said that they had not received pressure area care training Records showed that District Nurses are involved where necessary in the provision of wound care. Food and fluid monitoring charts were in place for a resident being cared for in bed. The records in place identified that either fluids were being offered very infrequently or that they were not being consistently recorded. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 11 Where resident’s display challenging physical and verbal behaviour, there was instructions for staff to follow to assist in defusing the behaviour to ensure that the resident’s personal care needs were met safely. Residents are unable to manage their own medication, the storage and administration was satisfactory, however there was medication which was prescribed as ‘when required’ given on a regular basis and night time medication omitted for one resident, this was discussed with the deputy manager, who said that the residents medication needs would be reviewed with their general practitioner to reflect the current practice. The medication policy was viewed and requires reviewing and updating to include the current medication administration system in use. Residents said that they are well cared for and felt safe living at the home, during a limited tour of the building there were residents spending time within their rooms through choice, listening to music and talking books. Staff were observed caring for residents with compassion dignity and respect. The resident’s wishes in the event of death were not fully completed within the care plans viewed. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 The lifestyle in the home meets the resident’s needs and expectations. EVIDENCE: The care plans contained information on each resident’s individual preferences in relation to daily living activities. There was a plan of organised activities to include armchair exercises, bingo, Beatle drive, and quizzes. The home employs an activity organiser who predominately works mornings, the staff said that they have access to the activity materials when the activity organiser is not on duty, facilitate a flexible approach to activities. Visitors were welcomed into the home by staff and could visit their relatives within their individual bedrooms or within the communal lounges. Individual choice is exercised in where residents choose were to take their meals To aid with orientation for residents who are visually impaired the home endeavours to ensure that routines and eating arrangements are consistent. Additional wall lights have been installed to the dining room to provide a bright well-lit environment. The meal on the evening of inspection was a selection of sandwiches and cakes. Residents said that they were pleased with the food available. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 13 Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The complaints procedure is available to all residents and their representatives. EVIDENCE: Residents and their representatives are provided with the homes statement of purpose and service users guide, which contains details on the complaints procedure. A copy of the complaints procedure is displayed within the entrance to the home, however it is not in a format that is suitable for the visually impaired. Minutes of residents meetings and residents concerns (grumbles) were viewed, no action was recorded for two of the concerns raised, for example cigarette smoke from the staff room and a resident feeling vulnerable unsupervised for a lengthy period of time within the conservatory, however through discussion with the deputy manager it was confirmed that action had been taken on these matters. The home has now introduced a no smoking policy, and staff are required to regularly check that residents sitting within the conservatory are safe and emotionally supported. Residents said that they would know who to forward their complaints to if the need arose. Staff training records demonstrated that training is provided on adult abuse awareness. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 15 Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 16 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): 19,20,21,22,23,24,25 & 26 Residents live in a well-maintained and homely environment EVIDENCE: The home has undergone extensive redecoration and refurbishment to include introducing colour coded handrails to corridors to aid in orientating residents around the building and upgrades to the bathrooms and toilets. The furnishings within the home was clean and homely, within the ground floor lounges several of the armchairs were electrically operated recliner chairs which have been donated to the home by families, during discussion with the deputy manager the inspector was informed that residents are unable to operate the chairs safely without supervision. Within the accident reports viewed there was an incident when a resident operated the chair by accident. The bathrooms and lavatories were clean and bright, with grab rails in strong contrasting colours to the bathroom furniture, to make them more visible. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 17 Hand sanitising gel was available throughout the home to reduce the risk of cross infection. There was tactile signage to identify bathrooms, toilets and the lift. There was specialist equipment available to include assisted baths that are under a maintenance contract. The bedrooms viewed were pleasantly decorated, well lit and personalised to the resident’s individual tastes. On some of the bedroom doors of residents who are at risk of falling, there were alarms fitted to alert staff that the resident is mobile and requires assistance. However through viewing the accident reports of residents who are at risk of falling, all the accident reports indicated that the resident had fallen within the bedroom before reaching the door Risk assessments are in place for the use of bedside rails, the bedside rails in use were of the types that are compatible with the bed, however through discussion with staff they were unaware of the dangers of bedside rails and the advice medical devises agency safety notice regarding their use. Documentation within the care plans demonstrated that families had given their consent to their use. Several of the resident’s rooms had telephones that were suitable for the visually impaired. There was sound activated door hold open devises in use on several of the residents doors the inspector was informed that there are areas of the building where sound activating devises would not respond to the sound of the fire alarm. The home has identified that there is a need for an additional fire alarm to be positioned within the building to allow for all residents to have the door hold open facility in place. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 18 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): 27,28,29 & 30 Residents are cared for by a trained staff team, however recruitment procedures need to be more thorough to provide better protection for Residents. EVIDENCE: On the afternoon of the inspection there was sufficient staff available to meet the current needs of residents, staff were observed spending time socialising with the residents. Staff recruitment documentation viewed had a shortfall in obtaining two written references, there was evidence that the referee had been requested on more than one occasion to supply a written reference, and there was a record of obtaining one telephone reference. The requirement to have all staff cleared with the criminal records bureau (CRB) is unmet, and efforts to obtain the clearance continue. The registered manager assured the inspector that employees would not be working unsupervised with residents, whilst awaiting CRB clearance. Staff training records were viewed the home has achieved the target set by the national minimum care standards act 2000 that at least 50 of the staff are trained to National Vocational Qualification level 2 by 2005. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 19 The training plan for 2005/6 was viewed, training records evidenced that staff receive mandatory induction training on moving and handling, food hygiene, fire procedure, health and safety, first aid, protection of vulnerable adults, control of substances hazardous to health and infection control. In addition to mandatory training, there is vocational training to meet the needs of the residents, such as medication, deaf blind awareness, communication skills, Parkinson’s and palliative care. Through viewing the care plans and talking with residents and staff it is apparent that there are residents living at the home who have short term memory loss, and dementia who require emotional support, dementia care training was not included on the annual training plan. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 20 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): 31,32,33,37 & 38 The management and administration at the home promotes the health safety and welfare of residents and staff EVIDENCE: A variety of records were viewed during the inspection and these were seen to be well maintained, up to date and accurate. Residents meetings provide a forum for residents to express their views, however there was no formal residents survey feedback system in place. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 21 Policies on medication, staff supervision and whistle blowing were available to view.The medication policy requied reviewing and updating to include the current medication storage system in use. Confidential records were stored appropriately. Care plans and risk assessments were regularly reviewed and contained information that was specific to individual residents needs and aspirations. The registered manager is suitably qualified, competent and experienced to manage the home, and is supported by a deputy manager who has achieved the National Vocational Qualification level 4 and registered managers award. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 22 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 2 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 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X 2 3 Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP8 Regulation 12 (1) (a) (b) Requirement Residents must receive fluids regularly and where a risk of dehydration is identified records must be kept of all fluids offered and taken (Previous timescale of 04/07/05 partially met) The medication policy must be updated to include the current medication storage and administration system in use within the home. Two written references must be obtained for all new employees, prior to commencing employment.. Timescale for action 31/12/05 2 OP9 13 (2) 31/12/05 3 OP29 19 Schedule 2 31/12/05 4 OP29 12(1)(a) (b) 19(1)(a) Satisfactory criminal record bureau clearances must be obtained for all staff prior to starting work in the home. (Previous requirement of 04/07/05 not met) 31/12/05 Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 24 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 2 3 4 5 Refer to Standard OP16 OP30 OP30 OP32 OP32 Good Practice Recommendations Within the front entrance the complaints procedure should be more visible in a format suitable for the sensory impaired To ensure that staff can continue to meet the changing needs of residents, training on dementia care should be provided To aid in the prevention of pressure ulcers, staff training in pressure care should be provided. Risk assessments for the use of electrically operated recliner chairs should be conducted following the medical devices safety notice guidance. All staff should be made aware of medical devices safety notices which are relevant to equipment in use in the home e.g. electrically operated recliner chairs and bedside rails. Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Darsdale DS0000012760.V267757.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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