Inspection on 04/05/06 for Dawes House

This inspection was carried out on 4th May 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Dawes House 04/10/07

Dawes House 14/12/05

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 10:00 4th May 2006 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.V292467.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 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 Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (6), Old age, of places not falling within any other category (29) Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th December 2006 Brief Description of the Service: Dawes House is a care home providing personal care 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. The most recent CSCI inspection report and information about the service are available in the reception area of the home. On the 6th June 2006 the manager confirmed that the fees charged by the home are: £485.85 per week for those residents funded by Wandsworth local authority £538.58 for privately funded residents. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 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 seven staff, three residents and viewing paperwork. A tour of the premises was carried out and care records were inspected. Information has also been gained from the inspection record for the home and surveys received from three health and social care professionals. 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 are highlighted in the report and were discussed with the manager during the inspection. These include improvements to the recruitment checks for staff, record-keeping in both the care files and activity records. There still need to be improvements to the décor inside the home to ensure that all areas are comfortable and homely for the residents. Another outstanding issue is that staff are trained in providing activities to the residents living at Dawes House. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 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.V292467.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made as the residents are well assessed prior to moving to the home. EVIDENCE: One resident commented: “…I’ve lived here for six weeks…I like it…”. The file for this resident contained evidence of an up-to-date social worker assessment that had been used by staff to plan their own assessment of the resident. At the same time the home had also received a summary of any risks to the residents safety that they would need to consider, and these were also followed up through the homes own assessment process. The homes own assessment process is detailed, and allows for cultural information to be included, such as food preferences, religious needs, etc. Intermediate care is not provided by the home. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 9 Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 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 and 10 Quality in this outcome area is good. This judgement has been made as the feedback received from health and social care professionals and residents indicates that their needs are well met. Also, good developments have been made to the care planning system, which is a positive step for the service. EVIDENCE: At the time of the inspection the care plan format was going through a period of transition to that of a much more simplified and useable system. Therefore only a small number of files had been transferred onto the new format. These care plans are much more easy to read and provide concise but detailed information about the residents needs and wants. Such examples of this was information on what each resident likes to do at different times throughout the day, if they like their food cut up, if they enjoy a cigarette, and details of favourite foods such as preferring English or Caribbean food. Staff are positive about the changes to the care plan format, stating that they give “…a better understanding of what is needed…”. Another staff member said that “…they are brilliant…” adding that “…they save time, allowing more time for communicating with residents…”. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 11 Feedback from the health and social care professionals was positive around the residents being treated with respect as individuals. In particular one professional praised the staff for taking the time to help residents settle into their new environment, saying that: “…clients are supported and helped to integrate and socialise with the other residents…”. During the inspection one resident also commented how they enjoy spending time watching television on their own, which the staff support them to do in the separate ‘quiet lounge’ on the unit. The health and social care professionals associated with Dawes House are positive about the service, commenting that “…the manager and staff endeavour to work with the clients to support their needs…” and that “…the home has a proactive attitude to supporting and caring for the residents…”. A further comment demonstrated that good links are maintained with health and social care professionals, where one said, “…the manager and her team are very willing to liaise and work with us…”. Medication at the home is managed well, with appropriate record-keeping and monitoring systems in place to ensure that this is given correctly. All staff who give out medication have received training on how to do this safely. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 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 and 15 Quality in this outcome area is good. This judgement has been made as the residents are involved in various activities both in and outside the home. Residents rights are respected in their daily lives, where the routines of the home are flexible, and the food caters for individual preferences. EVIDENCE: The previous inspection required that the service provide a range of suitable activities, that records are maintained of these and that staff providing activities are trained in this. The manager showed evidence to demonstrate that she has been in contact with a training provider to enable staff to receive training in motivating and providing activities for older people. On the day the inspector observed some activities taking place, such as residents being taken out to vote, plans to take a group of residents to the local pub and residents spending time sitting in the garden. Walking onto Richmond unit there was a lot of laughter occurring, where the carer was involving the residents in conversation about events that were reported in the daily newspaper. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 13 Residents spoke about how they also like to spend time on their own, one commenting that: “…I enjoy reading, I have lots of newspapers, I don’t like the TV…”. Another resident also discussed how they like to go out shopping on their own. The manager stated how she has been in discussion with residents and the local mobile library to arrange for literature and films to be provided for those residents from France, Spain, Africa, etc. She also said that she was looking into having volunteers at the home, and that she was currently liaising with the local authority over the provision of these. On each unit there is a record of activities that contains information such as residents reading the newspaper or a tossing ball. They also include personal care ‘activities’ such as bathing and nail clipping, which should not be recorded as an activity. The record keeping still needs to improve to ensure that personal care issues are not included as an activity. Also, the recording does not always appear to fully represent the activities that residents are actually involved in. This relates to those activities witnessed by the inspector and those described by the residents, yet none of these were recorded. The inspector observed lunches being served, where residents were seen enjoying the food in a relaxed atmosphere, eating at their own pace and with enough food available if they wanted a second portion. One resident who was waiting for their lunch said that “…the food is nice, its sausages or fish today, I’ll be having the fish…”. The menu was reflective of residents preferences as previously observed in the care plans – with a Caribbean curry having been prepared the day before, and sausage and mash on the days menu. The chef described that throughout the week there are two days where Caribbean food is given as an option, as well as a cooked breakfast being offered twice a week. The chef also spoke about the flexibility in the menu, demonstrating a detailed knowledge of the likes and dislikes of particular residents and how these can be catered for. There is a small kitchen area on each unit, where a resident said that: “…I can get a snack of biscuits and tea when I like…”. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 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 and 18 Quality in this outcome area is good. This judgement has been made as residents feel confident to raise areas of concern they have and systems are in place to reduce the risk to residents. EVIDENCE: The service has the Servite Houses complaints procedure that is provided in the Service Users Guide and Statement of Purpose for the home. Three residents said that they would talk to the manager or staff if there was something they were not happy about. Since the last inspection the home has obtained a copy of the Wandsworth Protection of Vulnerable Adults procedures. There are policies in place to increase the awareness of elder abuse. Staff records indicate that they have received recent training in abuse awareness, so to minimise the risk to residents. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 15 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 and 26 Quality in this outcome area is adequate. This judgement has been made as the staff and residents make the environment welcoming, however there are a number of areas of décor around the home that still require redecorating to make the house more homely for the residents. EVIDENCE: “…Dawes House has a homely feel and conversations between staff and residents are relaxed…”. This was a comment from a healthcare professional who visits the home. It also reflects the atmosphere at the home during the inspection, with the staff and residents being welcoming and a good rapport observed between all parties. The home is also cleaned to a high standard with a clean, fresh-smelling feel and consistent, cheerful domestic staff carrying out these duties. Dawes House is homely in most areas, with good lighting and ventilation in the communal areas, with new carpet having recently been laid in the dining area Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 16 of York unit. However the walls of the hallways still need to be re-decorated due to damp-staining from where a pipe had leaked in the roof. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 17 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 and 30 Quality in this outcome area is good. This judgement has been made because the service ensures that staff are trained and supported in their role. However, they need to ensure that thorough recruitment checks have been carried out on all staff. EVIDENCE: The home holds recruitment information on each member of staff. Three staff files were examined and found to contain most of the relevant information such as proof of identification, two references and record of the interview of staff. One file contained a Criminal Records Bureau check from a different employer and it is required that the home ensure that these are carried out with them as the current employer. The staff files contain records of the staff appraisals carried out earlier this year. The manager stated that she is using the information gained from these to enable more structured supervision sessions with staff. She demonstrated how the appraisals have enabled her to analyse the training needs of the staff and plan the training for this year. Staff discussed that they receive supervision approximately every one to two months from the assistant manager or a senior member of staff. One staff talked about the training they have received in Protection of Vulnerable Adults, care planning and giving medication. Another member of staff talked about having completed the NVQ level 2 in care, stating that she feels “…competent and well-trained to do her job…”. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 18 The home maintains a record of the training completed by staff and that which they are due to commence soon. Dawes House maintains a number of staff who have worked at the home for a number of years and have a good working knowledge of the residents, and working with older people. There is a shortage of approximately three care staff and one senior at the home and the manager stated that the vacancies are currently being recruited for. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 19 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, 35, 37 and 38 Quality in this outcome area is good. This judgement has been made as there is a committed and competent manager at the home who has helped to progress the service for the benefit of the residents. However, record-keeping in residents files is not of a sufficient standard and this must be addressed by the service. EVIDENCE: Health and social care professional involved with Dawes House gave positive comments about the manager, stating that “…the manager communicates clearly and accurately with any issues of concern…” and “…I think the home is very well organised…”. Another professional commented that“…the home is improving and all efforts are being made to do this…”. These comments are good and highlight the professionalism of the manager. Observations and discussions with the residents during the inspection were positive, indicating that the manager is respected and well-liked by the those living and also those working at the home. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 20 The improvements since the last inspection demonstrate that the home has a committed and competent manager who promotes the choices and interests of the residents and who sets good standards. The home holds a personal allowance for each resident that is funded by themselves, their family or through social services. This money is used for when a resident wants to go shopping or use the hairdresser, etc. Three residents cash balance was checked and found to correspond with the records and receipts. The cash is kept in an individual wallet for each resident, in a locked tin. The home does not hold a Power of Attorney for any resident, and the manager said that the social services would be contacted to arrange this for any residents needing this. The recording in the daily care notes for each resident needs to be improved significantly. This is because the level of recording is does not give adequate detail about what each individual has done throughout the day. A particular example of this is where the daily records for one resident said one of the following sentences: “…assisted with personal care, assisted with medication,…provided with meal/ plenty of fluids…”. The records available for this resident indicate that these were the only statements used from the start of the year to describe what the resident does throughout the morning, afternoon and night. One healthcare professional also identified that there is a “…need to improve the documentation…”. This is not at all sufficient and it is required that all staff are provided with record-keeping training to ensure that the daily notes detail the individual activities and occurrences for each resident on a 24-hour basis. The home maintains records to demonstrate that appropriate health and safety checks are carried out on the fire system and equipment, fridge and freezer temperatures and water temperatures, gas safety and Portable Appliance Testing, etc. Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 2 3 Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16(2) (m)(n) & 18(1) Requirement The Registered Persons must ensure that full records are 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 the walls in all hallways and units on the first floor are redecorated to a good standard. (Within timescale at time of inspection) The Registered Persons must demonstrate that a Criminal Records Bureau check with Servite Houses as the employer has been obtained for all staff employed at the service. The Registered Persons must ensure that staff are trained in good record-keeping techniques, with particular reference to recording in daily notes of residents. Timescale for action 31/07/06 2. OP19 23(2)(b) & (d) 30/06/06 3. OP29 19(4), Sched 2 31/07/06 4. OP37 17 30/09/06 Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 23 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.V292467.R01.S.doc Version 5.1 Page 24 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. Extracts may not be used or reproduced without the express permission of CSCI Dawes House DS0000010185.V292467.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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