Inspection on 14/12/05 for Dawes House

This inspection was carried out on 14th December 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

Dawes House 04/10/07

Dawes House 04/05/06

Dawes House 15/12/04

Dawes House 29/07/04

Dawes House 24/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Townley Road, 2-3

Orchard House Nursing Home

St Josephs Rest Home

Foxley Lane (121a)

Tudor Lodge

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

CARE HOMES FOR OLDER PEOPLE Dawes House 6 Bramlands Close London SW11 2NS Lead Inspector Louise Phillips Unannounced Inspection 09:10a 14 December 2005 th 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 Dawes House DS0000010185.V269610.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. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dawes House Address 6 Bramlands Close London SW11 2NS 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) 020-7223-5002 020 7223 3957 Servite Houses Mrs Locardia Munikwa Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2005 Brief Description of the Service: Dawes House is a care home providing personal care and accommodation for 29 older people, including up to six people with a mental disorder, excluding dementia. The service is owned and managed by Servite Houses. The home is situated on a residential estate and is within easy reach of Clapham shopping centre. There is good access to public transport links and the home is located very close to Clapham Junction railway station. Dawes House is a purpose-built two storey building divided into three units. Each unit has it’s own lounge, kitchen/dining area, quiet lounge, bathrooms and toilets. The two floors are served by a lift. Residents are able to utilise the large communal lounge on the ground floor and the secluded garden adjacent to this. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day with time spent talking to the manager, residents, staff and viewing paperwork. A tour of the premises took place and staff and care records were inspected. Six of the staff on duty and five of the residents were spoken to during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Areas where the home could be doing better were discussed with the assistant manager. These include improvements to the care planning processes and the activities provided by the home. There were also a number of issues in the environment of the home that need to be addressed to ensure that the home is safe and comfortable for the residents. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 6 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. Dawes House DS0000010185.V269610.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 Dawes House DS0000010185.V269610.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, 3 and 4 Information at the home provides relevant details about the service and facilities available. Positive developments have been made to the service to ensure that Dawes House is the right home for people moving there. EVIDENCE: Since the last inspection the service at Dawes House has been developed to allow for up to six people with a past or present mental health problem to live there. The Service User Guide has been updated to include these changes and provide the relevant information about the home. A further development to the service has been the implementation of new documentation to ensure that all residents are appropriately assessed prior to moving to the home. At the time of inspection this had only just started to be used by the staff and so could not be adequately assessed. However, discussion with staff highlighted that they felt the introduction of this was positive and enabled all residents to be re-assessed to ensure that they were receiving appropriate care. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9 The new care planning system is difficult to understand and needs to be simplified. Good improvements have been made to ensure that residents are given their medication correctly. EVIDENCE: The previous inspection of Dawes House raised concerns about the new format of care planning that was due to be implemented at the home. A requirement was made for this to be simplified to a format that was more easier to understand and accessible to the staff and residents at the home. Following a discussion between two area managers of Servite Houses and the CSCI in October 2005 it was agreed that this care plan format could be implemented on a ‘pilot’ basis for a period of six months, where the use of this would then be reviewed and changes made where necessary. It is anticipated that the findings of this inspection will be used to inform the review. At the time of the inspection the new care plan format was being implemented, with residents being re-assessed and new care plans being developed. The new care plans were also being put onto the computer. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 10 Three staff were spoken to about how they found using the new care plan format. The responses were: “…it does help us know a lot about the resident…” “…it’s like doing a test…” “…it’s confusing…” “…made things more difficult…” “…I had training in how to write new care plans, but I still don’t understand….” On being able to put the care plans on computer, the general response was positive with staff stating that there was more flexibility, “…as I can move lines to put in more writing…”. However, it was observed that there had been care plans written that were not relevant. This is in relation to areas that were not assessed as having a need, eg. eating and drinking, and where a resident was assessed as having no problems with sleeping, yet a care plan was implemented for this. It was noted that good improvements had been made to the medication records, which were all signed appropriately. This good practice has been enhanced by them being checked by a senior and a carer at the end of each shift. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 11 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 and 14 The home does not demonstrate that it provides adequate activities to the residents. Staff demonstrate a good awareness of the needs of residents, and communicate appropriately with each individual. EVIDENCE: There continues to be no activities co-ordinator and the home and the inspector was informed that the care staff initiate activities with residents when they can. A record of activities by care staff is kept on each unit, detailing those that have occurred in the morning and during the afternoon. Such activities are recorded as ‘day centre’, ‘read newspapers’, ‘watch film’, ‘board games’, ‘manicure’ and ‘kicking a ball’. Some of the other items recorded as an activity are actually personal care issues and should not be recorded as being an activity, eg. ‘nail cutting’ and ‘massaging hands and legs’ – which the inspector was informed was where cream is applied to these areas. There is also no indication that staff are trained in massage and manicure and it is required that staff receive training in these areas. In each unit there is displayed a timetable of activities for the week. On the day of inspection reminiscence and games were planned, though these were not seen to occur. Observations of throughout the day, and records of Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 12 activities undertaken indicate that activities occur on a more ‘ad hoc’ basis and whilst some are planned, these do not always take place. It is acknowledged that progress has been made to provide some activities at the home in the absence of a dedicated activities co-ordinator, which is recommended for the service. However the home must ensure that staff are appropriately trained for the activities they are expected to carry out and that the record of activities does not include areas of personal care. At different times throughout the inspection the staff were observed demonstrating a respectful and caring approach towards the residents. Such examples are where staff were seen knocking on the doors to residents rooms and waiting for an answer and where they provided assistance with walking, which varied from providing an arm for the resident to hold and gentle prompting. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 13 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): 18 Staff training and information available ensures that the risk of abuse to residents is minimised. EVIDENCE: Records indicate that all staff have received recent training in the Protection of Vulnerable Adults. There are good policies in place to raise the awareness of elder abuse, with procedures describing steps that can be taken to prevent abuse eg. thorough recruitment checks and actions to take if abuse suspected. It is required that the home obtain a obtain a copy of the Wandsworth Protection Of Vulnerable Adults guidelines. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 14 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 and 21 Improvements have been made to the environment, but further progress is needed to make Dawes House more comfortable and homely for the residents living there. EVIDENCE: A number of improvements have been made to the environment with the completion of a shower room on each unit. These have been decorated to a good standard and are homely and inviting. One staff member commented that “…residents prefer having a shower, and it is easier to help them wash their hair…”. A further improvement has been the re-positioning of the reception/ senior carers station at top of stairs, at the centre point of the three units. This is a positive change as it enables easier access to all units and was also seen to be somewhere that residents can go to and rest, whilst chatting to the senior staff on duty. Some areas of improvement were noted as needing attention, particularly the carpets in the kitchen/ dining area of York unit, which were in a poor state. In addition, ripped carpets were observed in the hallways of Richmond Unit. The Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 15 bathroom on York unit was observed to be inaccessible due to being cluttered with two wheelchairs, two hoists and other items of furniture. Inside the entrance to Edinburgh unit the radiator cover was found to be in need of repair as it is coming away from the wall. The fire exit in the small lounge on Edinburgh unit also needs to be adjusted to ensure that it does not require the use of a key to open it, and appropriate fire exit signage also needs to be displayed in this area. On entry to Richmond unit the ceiling was noted to have a large damp stain, and another was also observed on the ceiling at the top of the stairs to the first floor. Furthermore, the walls in Richmond unit, particularly around the doorframe to bedroom 75, were seen to be cracked and badly marked. The walls in all hallways and units on the first floor could benefit from redecoration to brighten up the areas and make these more homely for the residents. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 16 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): 28 and 30 Residents benefit from a committed and experienced team of staff at the home who have the right approach to meet their needs. All staff are well supervised by the manager and senior staff. EVIDENCE: Observations of the staff throughout the inspection were positive, and one resident commented that “…the staff are good…”. This gives the impression that the residents’ experience of the home is of a caring environment where they feel looked after. Most staff have worked at the home for a number of years and have built up a good knowledge and understanding of the needs of the residents. Staff files showed that most staff had done training in essential areas, such as first aid, abuse awareness and administering medication. Some staff are currently undertaking NVQ Level 2/ 3 in Care training to improve their competences further. As a result residents get a good quality of support and care from the staff at the home. Good developments had been made on the training records for staff, with a file listing all training undertaken by staff and the certificates to evidence this, with a separate file for future training planned and booked. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 17 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 and 36 Residents really benefit from living at Dawes House because the home is run well and in the best interests of the residents. EVIDENCE: “…she makes you feel comfortable, she does a lot for the home…” “..she always wants things done right…” These are some of the comments from staff about the manager of Dawes House. These, along with recent improvements at the home demonstrate that the manager’s approach and style of leadership is positive and that she works proactively to empower the team by encouraging staff to take on new roles to develop themselves. All staff have the opportunity to discuss work-related issues with the manager or senior staff on a regular basis during supervision sessions, and also with the team during monthly staff meetings. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 18 Discussion with staff convey that there is a good team working at Dawes House and that they are committed to supporting the needs and interests of residents at the home. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 19 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 X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 2 2 X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 X X Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 20 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 OP7 Regulation 15(1)(2) Requirement The Registered Persons must ensure that the new care plan format to be implemented at the home is in a format that is easily understandable and accessible to the staff and residents. (Previous timescale not met) The Registered Persons must ensure that a range of suitable activities within and outside the home are provided to residents on a regular basis. Full records must be maintained of actual activities provided. Staff providing activities must receive training appropriate to the work they are asked to perform. (Previous timescale not met) The Registered Persons must ensure that a copy of the Wandsworth Protection of Vulnerable Adults procedures is obtained for the home. The Registered Persons must ensure that: - the radiator cover on Edinburgh is repaired. - all fire exits are able to be DS0000010185.V269610.R01.S.doc Timescale for action 30/04/06 2. OP12 16(2) (m)(n) & 18(1) 28/02/06 3. OP18 13(6) 31/01/06 4. OP19 23(2)(b) & (d) 30/06/06 Dawes House Version 5.0 Page 21 5. OP20 23(2)(b) 6. OP21 23(2)(j) opened without the use of a key. - that appropriate fire exit signage is displayed in all areas. - that the walls in all hallways and units on the first floor are redecorated to a good standard. The Registered Persons must ensure that the carpets in the all the units are presentable and in a good state of repair. The Registered Persons must ensure that the furniture is removed from the bathroom on York Unit and that this is accessible at all times. 31/03/06 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations The organisation should consider having dedicated hours for a member of staff to provide activities. Dawes House DS0000010185.V269610.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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. 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