Inspection on 20/01/09 for Dawn Residential Home

This inspection was carried out on 20th January 2009.

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

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

Other inspections for this house

Dawn Residential Home 05/12/06

Dawn Residential Home 11/10/05

Dawn Residential Home 02/03/05

Dawn Residential Home 28/09/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Dawn Residential Home Cott Lane Dartington Totnes Devon TQ9 6HE     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Judy Hill     Date: 2 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Dawn Residential Home Cott Lane Dartington Totnes Devon TQ9 6HE 01803862964 01803840979 dawnresthome@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Kenneth Ian Barker,Mrs Gillian Moira Barker Name of registered manager (if applicable) Mrs Shelia Joyce Baker Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 18. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Dawn is a detached residential home that is set in an acre of grounds with scenic rural views. It is registered to provide accommodation and care for up to 18 people who are over 65 years of age in the category of old age only. Accomodation is provided on three floors and their is a passenger lift to aid mobility. Care Homes for Older People Page 4 of 26 care home 18 Over 65 18 0 Brief description of the care home There are three lounges and a dining room on the ground floor. Ample off street parking is provided for visitors and staff. The gardens are attractive and provide a pleasent outdoor area for the residents. The home is situated on the outskirts of Dartington, near Totnes. There is an accessible local bus service and a pub close by. The fees range from £430 to £465 a week. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was completed with an unannounced site visit that was carried out by one inspector on 20th January 2009. The information contained in the report gained from conversations with the registered owners, the registered manager, the staff on duty, the people who live at Dawn Residential Home and visitors to the home who were met during the site visit. Information was also gained from an Annual Quality Assurance Review that had been completed by the management of the home and returned to the Commission and from surveys completed and returned by residents and staff. Care Homes for Older People Page 6 of 26 Additional information was gained from the homes recently service history, their Statement of Purpose, Service Users Guide and Brochure. During the site visit we carried out a tour of the premises and looked at some of the homes records including staff recruitment and training records and residents needs and risk assessments, care plans and reviews. What the care home does well: What has improved since the last inspection? What they could do better: The provision of staff training could be better. Staff views could be included in the quality assurance programme. Written policies, procedures or codes of practice should be provided on the annual development planning, bullying, discharge of residents, including planned discharge and termination or self-discharge at short notice and record keeping. Care Homes for Older People Page 8 of 26 More care could be taken to ensure that domestic chemicals are kept in locked storage facilities. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient information is given to prospective residents about the home and the services provided to enable them to make an informed decision about where they live. Prospective residents can be confident that the home will complete an assessment to determine whether or not their needs can be met. Evidence: Several of the people who live at Dawn Residential Care Home told us that either they or their families had visited a number of care home in the area before choosing to move into this home. None of the residents told us that regretted their choice of home. One resident told us that that her decision to move into the home was the best decision she had ever made and another told us that she was so happy with the service that she had recommended the home to a friend. A sample of written individual needs assessments were inspected during the site visit Care Homes for Older People Page 11 of 26 Evidence: and found to contain all of the information needed to identify the residents needs and to form initial care plans. Dawn care home does not provide intermediate rehabilitative care although they will provide respite for agreed periods of time if they have a room available. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a clear and consistent care planning process and the good working practices followed by the management and staff ensures that residents personal, social and healthcare needs are met. Evidence: Samples of individual care plans were inspected during the site visit and these told us that care planning practices take into account the health, personal and social care needs of the people who use the service. Daily records are written by the care staff after each of their shifts and handover meetings are held to ensure a continuity of service. The individual care plans are reviewed regularly to ensure that any changes to the residents needs are recorded and can be met. The physical and mental health of the people who use the service is monitored and any Care Homes for Older People Page 13 of 26 Evidence: concerns are referred to the professional healthcare services. Several of the residents have poor mobility but the design of the home and the mobility aids provided enable the staff to assist them safely. The Annual Quality Assurance Assessment tells us that several residents are incontinent but none of the obvious signs of this were detected during the site visit. This tells us that effective continence control practices are being used. Some of the residents have maintained control of their own medication but most of the medicines are administered by care staff who have been appropriately trained. The medication is stored appropriately and the medication administration records were seen to be clear and up to date. Residents spoken with during the site visit and those who completed and returned surveys to the Commission told us that the home is meeting their needs. The residents spoken with during the site visit told us that they were very happy with the quality of care provided. Many positive comments were received about the care staff, the registered manager and the owners. Throughout the inspection the residents were seen to be treated with dignity and respect by the staff and management. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are able to participate in a range of activities if they choose to do so. The quality of the meals provided is excellent. Evidence: Feedback from surveys completed by some of the residents tell us that group activities organised and that they can take part in them if they choose to do so. Notices seen displayed in the home during the site visit told us that these activities are varied and include scrabble sessions, musical entertainment and arts and craft workshops and flower arranging. On the day of the site visit one of the residents held a poetry recital and was keen to encourage other residents to take up writing. Although organised activities take place three days a week, some of the residents told us that they would like more activities to be organised. Most of the residents have families who take them out regularly, but occasional outings are arranged by the home and the staff said that they do take residents out for Care Homes for Older People Page 15 of 26 Evidence: short walks. A patio to the back of the house and the front garden provide easily accessible and very pleasant outdoor areas for the residents to use. The home has three separate lounges, one is used as a television room, one as a music room and one as a quiet lounge. The mobile library service keeps the residents well equipped with large print books and the home has a large selection of books for the residents to read if they wish to do so. One of the residents told us that she has continued to work as a translator since coming into the home. A number of relatives visited the home during the site visit and it was observed that they were all made welcome and offered refreshments. One visitor told us that she visits two or three times a week, that the home is always clean and pleasant and that her relative is very well cared for. The residents can receive their visitors in the privacy of their own rooms or in one of the communal lounges. We received so many positive comments from the residents about the quality of the meals provided that we must conclude that the quality of the meals provided is excellent. We spoke to the chef and he told us that he could provide meals for people who have special dietary requirements if necessary. We were told that the chef visited each of the residents on a daily basis to tell them what the planned meals were for the following day and to record their preferences. Alternatives to the planned meals are provided if requested. The chef said that he always prepared a vegetarian meal and a meat dish. One of the residents told us that although the food was excellent, although she would like to be offered more fresh or stewed fruit. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives can be confident that any concerns or complaints that they may have about the service will be taken seriously and dealt with sensitively. Evidence: The complaints procedure is included in the homes Statement of Purpose and Service Users Guide. Surveys completed and returned by the residents told us that they would know what to do if they were unhappy about the service and needed to make a complaint. Only one complaint had been recorded in the homes complaints book and this had been dealt with appropriately. We were told that most of the staff had received training in the Protection of Vulnerable Adults. Relevant written policies and procedures are kept at the home and accessible to the staff to ensure that they are aware of the action they should take if they feel that a resident is or may be at risk of abuse. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Dawn provides the residents with an exceptionally well presented and thoughtfully designed home. Evidence: Dawn is situated in a very beautiful and quiet location on the outskirts of the village of Dartington. It is very close to the village pub but some distance from the local shops. Although the original parts of the house are very old, two modern extensions have been added. The extensions have been carefully designed to ensure that they compliment the original features of the house and provide a home that is suitable for people with poor mobility. The home was seen to be well decorated, comfortably furnished and clean throughout. There are three separate lounges, one is used as a television room and the other two are quiet lounges where the residents can sit and listen to music, read a book or entertain their families and friends. The dining room is large enough to accommodate all of the residents in a single setting and it was noted that the tables are very nicely laid at mealtimes. Care Homes for Older People Page 18 of 26 Evidence: The residents bedrooms are all well presented and some of the have spectacular views of the South Hams countryside. One of the bedrooms is registered as a double room but is currently being used as a single room. All but two of the bedrooms have en suite facilities. The communal bathrooms and shower rooms are well equipped for people who have physical disabilities and may need assistance from the staff. Communal toilets are well sited. The kitchen and laundry facilities are suitable for the needs of the home. The residents accommodation is on three floors and a passenger lift is provided for ease of access. Dawn is a detached house and is set in its own grounds. There is ample off road parking for the staff and visitors to the home. The gardens also provide a pleasant outdoor area for the residents to sit or take exercise in. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Dawn can be confident that they will be looked after by caring and conscientious staff. Evidence: The staffing levels are maintained at a level that is high enough to meet the needs of the people who use the service. Senior care workers are employed as team leaders so there is always a named person in charge of the home. In addition to the care staff there is a chef and two housekeepers. The registered manager and registered owners also work at the home on a daily basis. The owners home is in the grounds of the registered home and so they are usually available on-call when they are not at the home. Very positive feedback was received from the residents and visitors to the home about the care and conduct of the staff. We looked at samples of staff recruitment records and saw that safe recruitment practices are being used to ensure that unsuitable staff are not employed to work with the residents. Records of staff training, surveys completed by some of the staff and conversations Care Homes for Older People Page 20 of 26 Evidence: with the staff told us that although training is provided, this provision could be improved. It was suggested that the staffs individual training needs and achievements could be discussed with them during individual supervision. Full staff meetings are not held on a regular basis but handover meetings take place between shifts and the registered manager and owners were described by the staff as approachable and supportive on both a professional and personal basis. The number of staff who currently hold National Vocational Qualifications in Care is a little low but several members of staff are currently working towards gaining this qualification. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This is an exceptionally well managed, well presented and well maintained home. Evidence: The registered manager is Mrs Sheila Baker. Mrs Baker has worked at the home for over ten years and has worked her way up to being the manager of the home. She has completed a National Vocational Qualification in Care at Level 4. One of the registered service providers, Mrs Gill Barker, is also actively involved in the day to day management of the home, while Mr Barker deals mainly with the repairs and maintenance of the home. Feedback from the residents and staff tells us that the registered manager and the registered owners are highly respected and that they all work very well together. The residents are encouraged to continue to handle their own financial affairs when Care Homes for Older People Page 22 of 26 Evidence: they come into the home or to ask their family of a legal representative to assist them. The home will look after small sums of money for the residents and individual records are kept of incoming and outgoing amounts. Quality assurance questionnaires have been distributed to residents, families and other agencies including GPs and District Nurses. This information has been collated to identify the aspects of the home and care service that the home is getting right and areas that may need improvement. It was suggested that the views of the staff could also be included in the homes quality assurance programme and that the process is carried out annually. The Annual Quality Assurance Assessment that had been completed and returned to the Commission tells us that most of the required and recommended written policies and procedures are kept at the home. The staff are aware of and use safe working practices to care for the residents, although it was noted that domestic cleaning products are not always kept in locked storage cupboards when they are not in use. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 24 Each of the residents should be provided with a lockable facility in their rooms in which to store their money and other valuables. The views of the staff could also be included in the homes quality assurance programme and the process should carried out annually. Written policies, procedures or codes of practice should to be provided on the Annual Development Planning, Bullying, Discharge of residents, including planned discharge and termination or self-discharge at short notice and Record keeping. All domestic chemicals should be kept in locked storage facilities when they are not in use. 2 35 3 38 4 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!