Inspection on 14/10/08 for Defoe Court

This inspection was carried out on 14th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Defoe Court 19/02/08

Defoe Court 16/05/07

Defoe Court 20/06/06

Defoe Court 28/11/05

Defoe Court 06/06/05

Defoe Court 16/12/04

Defoe Court 10/06/04

Defoe Court 05/03/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

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Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Defoe Court Defoe Crescent Newton Aycliffe Co Durham DL5 4JP     The quality rating for this care home is:   one star adequate 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: Hilary Stewart     Date: 1 4 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 27 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 27 Information about the care home Name of care home: Address: Defoe Court Defoe Crescent Newton Aycliffe Co Durham DL5 4JP 01325316316 01325316633 defoecourt@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Southern Cross Home Properties Limited care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodation is: 41 The registered person may provide the following category of service only: Care home with nusing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 31 Physical disability - Code PD, maximum number of places: 4 Dementia - Code DE, maximum number of places: 10 Date of last inspection Brief description of the care home Defoe Court is a registered care home with nursing. It is owned by Southern Cross Home Properties Ltd and located in a residential area of Newton Aycliffe, close to all local amenities. The home is situated in its own private grounds and provides personal care and accommodation for up to 41 older people. The home is purpose built for older Care Homes for Older People Page 4 of 27 Over 65 0 31 0 10 0 4 Brief description of the care home people and is on two floors. Personal accommodation and communal areas are located on both floors. Service areas are located on the ground floor. Care Homes for Older People Page 5 of 27 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: one star adequate 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: Before the inspection visit we looked at, Information we have received since the last visit on 19th February 2008. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and the staff. An unannounced visit was made on 14th November 2008. During the visit we talked with people who use the service, staff and the manager, looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable, Checked what improvements had been made since the last visit. Care Homes for Older People Page 6 of 27 We told the manager what we found, At the time of the visit the home had a new manager who had been in post for two weeks. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The home charges from 434.50p to 603.98p per week. What the care home does well: What has improved since the last inspection? What they could do better: If repairs were carried out in the bathroom and the toilet seat repaired. Also if some of the beds were replaced or repaired this would make it less likely that the people who live at the home or a member of staff may injure themselves. If all of the care plans had sufficient detail and all parts of the plan were completed, Care Homes for Older People Page 8 of 27 staff would know that the information in them was up to date and correct. This would mean that they would have the information they need to be sure they were providing the people at the home with the support and care they need. Staff recruitment records need to show that all of the staff have been properly vetted and this would demonstrate that the organisation have made sure that they only employ suitable people to work at the home and therefore safeguard the people who use the service. Staff should receive individual supervision at regular intervals and this would support them to run the home and make sure that the people who live there are well cared for. If the staff at the home all had up to date training in adult protection procedures and were informed of the whistle blowing procedure this would make them more skilled at safeguarding the people at the home. Staff fire instruction will make sure that staff are clear about what they must do in the case of a fire to keep the people at the home as safe as possible. If the homes quality assurance system was fully implemented so that their was an annual development plan, this would build on the existing ways in which the people who live at the home; their families, friends and relevant people in the local community are consulted about the quality of care provided at the home and how it should be developed. 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 27 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 27 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. People have their needs assessed before they are offered a place at the home. This makes sure that only people whose needs can be met at the home are offered a place. The home does not provide intermediate care. Evidence: People have been assessed by their care manager before they move into the home. The manager said that they look at this assessment to see if the home can meet the persons needs. They also carry out an additional pre admission assessment prior to the person moving in. People can visit the home and this can help them make an informed decision about whether they want to move into the home or not. Care Homes for Older People Page 11 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All of the people who live at the home have individual care plans through which staff monitor and promote their health and to maintain their well-being. This helps the people stay healthy.Some care plans need more detail. The manager and staff in most areas respect the privacy and dignity of the people who live at the home. This is so the people know that they are valued as individuals. Evidence: The manager said and records showed that each person who lives at the home has an individual care plan, which is based on their assessment of need. Plans are reviewed and updated regularly. Most records showed that each persons changing needs are clearly recorded although some needed more detail about how to meet their social care needs. One care plan included social inclusion but did not cover the persons interests, hobbies and social contacts. There are risk assessments and moving and handling plans for each individual. In one persons care plan the falls risk assessment had not been completed and other risk assessments were not dated. The person had moved into the home in 2005. Care Homes for Older People Page 12 of 27 Evidence: There are procedures for staff to follow when they deal with medication. The manager said that all staff have received training in how to safely administer medication. Storage of medication was not well organised and the room did not have any work surfaces for staff to use. The medication records were up to date. Records showed that the peoples health care needs are met at the home. Details of visits by the district nurse; visits to their GP and hospital appointments are recorded in the individual files. The manager said that the health and welfare of the people who live at the home is monitored all of the time. At the time of the visit a chiropodist was observed treating people at the home. They were treating one person in one of the living rooms. Another two people who live at the home were in the living room in full view of the person being treated. The manager and staff when asked said that the people did not mind having the chiropodist treat them when other people were present, however this was not recorded in the care plan. The people who live at the home looked comfortable. One person said, I am satisfied with the service on relative said, I am generally very satisfied with the care and support provided by staff and the staff are kind. Staff were observed knocking at peoples doors and waiting before they entered. There seemed to be a pleasant rapport between staff and the people who lived at the home. Care Homes for Older People Page 13 of 27 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 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 the home are able to follow their own daily routines, which satisfy their social, cultural and religious needs. They can see their family and friends at any reasonable time. This helps to prevent them from feeling and becoming isolated. Meals at the home are varied and nutritious which promote the peoples health and well-being. Evidence: The manager and staff said that they arrange a variety of outings for the people who live at the home. Activities take place with individuals or as a group activity. They seek the views of the people at the the home and ask them what they would like to do. The manager said that the activities are aimed at physical, social and mental stimulation. Minibus trips occur on a regular basis and include both places of interest, places to eat, theatres and shows and coastal tours. They also have outside entertainers come and perform. During the visit a lot of the people were in their rooms. One persons said they play bingo on Tuesdays another said that there are activities organised by the home. Records showed a mini bus trip had taken place during September and the activites coordinator said that they try to have one group activitiy and spend some Care Homes for Older People Page 14 of 27 Evidence: time with a different person individually each day during the week. One person said I am bored I would like to get out more and another said that they thought that the staffing levels had affected the how often people could go on trips out. One person said about their relatives care I am generally satisfied with the care and support provided by staffand the staff know what is needed. The manager, staff and the people who live at the home said that relatives and visitors are welcome and encouraged to visit at any reasonable time throughout the day and evening. Visitors were observed during the visit, one relative said, we can visit at any time. The manager said that the people who live at the home had been asked their opinions on the food provided. They had a positive response and the menus are based on the likes and dislikes of the people who live there. The cook said that there are choices at meal times and if people want something different they will make it for them. Special diets can be catered for. Hot drinks and snacks are always available throughout the day and evening. The kitchen was well stocked and there were fresh fruit and vegetables. One person said, the food is very good and another said I cant grumble. Staff were observed sitting with people at meals times and talking with and supporting them. The manager said that people can choose to eat in their rooms if they wish, staff support is provided when needed. Care Homes for Older People Page 15 of 27 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 adequate 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 satisfactory complaints procedure which means that any issues are dealt with effectively so people know that their comments are taken seriously. Adult protection procedures to protect the people at the home from risk of harm are currently in place. However, formal training has not yet been given to all staff at the home, which diminishes the robustness of the procedure, as staff do not effectively recognise when to raise an alert . Staff whistle blowing procedures are in place as well but some staff are unaware of them and others do not feel confident enough to use them. Evidence: The manager said that the homes complaints procedure is always accessible to the people who live at the home and their relatives. The complaints procedure is also described in the homes statement of purpose, which everyone gets a copy of when they first move in. On person said that they would let staff known if they were unhappy about something, a relative when asked did know about the homes complaints procedure and said the staff communicate well with us. The manager said and records showed that there had been two complaints made since the last inspection. They said that they have both been resolved. The manager said that a complaints register kept in the managers office with all the relevant forms, spare forms are kept in the nurses office for out of hours complaints. Care Homes for Older People Page 16 of 27 Evidence: The manager said that all new staff receive training in how to safeguard the people in their care. However some staff said that they had not had this training and were not clear when asked about the procedures. Records showed that some staff had received training. The home has a whistle blowing procedures for staff the manager and some staff said that they were aware of what procedure they could follow if they had concerns. Some of the staff said that they were not confident with this procedure and were concerned if they did raise issues they would suffer repercussions. Three staff were not clear about the procedure or what it was for. Care Homes for Older People Page 17 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, comfortable and clean home, although some repairs are necessary. Evidence: There are enough bathrooms and showers for the people who live at the home. One of the bathrooms had some tiles missing, the toilet seat was broken, the plug in the bathroom was broken and there was a damp patch above the shower. The manager said that the bathroom is not usually used. Another bathroom had two urine bottles left in it and the soap dispenser had dripped down the wall and looked unpleasant. A lot of the emergency pull cords were found to be tied up which would have made them out of reach if people needed them. Each person has their own bedroom and they looked comfortable and clean. They were all personalised and made very individual. One bedroom had an unpleasant odour; the manager organised to have this rectified. In another bedroom the bed was broken. The laundry room at the home was clean and well organised. Washing had been separated and there was a sluice facility. The kitchen looked clean and hygienic apart from some damaged flooring which the manager said should be repaired in the near future. Care Homes for Older People Page 18 of 27 Evidence: Overall the home is clean and nicely furnished Care Homes for Older People Page 19 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have opportunities for training so they know how to give the people who live at the home good care and meet their needs. Formal training in safeguarding vulnerable adults has not yet been given to all staff at the home, which may mean that some staff dont recognise when to raise an alert. Most of the time sufficient numbers of staff are in post to meet the needs of residents. The home has a recruitment procedure to make sure that only suitable people come to work there. Some of the vetting process had not been carried out in full. Evidence: The manager said that twelve of the staff have vocational qualifications. Records showed and staff said that they have mandatory training, such as first aid and food hygiene. Staff said that they receive training which helps them with their work and they receive mandatory training. Sufficient staff were on duty during the visit and the manager said that enough staff work at the home. However some staff and the people at the home said that the home would benefit from having more so they could spend more time with the people individually. Some of the people at the home said that the staffing levels at times had affected their care. If they called for a member of staff sometimes they had to wait. The manager said that they had used some agency staff to cover the rota. Care Homes for Older People Page 20 of 27 Evidence: The manager said that all staff have been CRB (Criminal Records Bureau) checked at an enhanced level to make sure they are suitable people to work at the home. Records showed that checks had been carried out before staff started to work at the home. Some of the records could not confirm that checks on peoples previous employment had been carried out. Care Homes for Older People Page 21 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is qualified and experienced and plans to run the home in the best interests of the people who live there and the home has procedures in place that make sure the people who live there are protected as much as possible although staff fire instruction was not being recorded. Staff were not receiving individual supervision as often as they should. Evidence: The manager said that they are qualified and experienced to run the home effectively. It was observed that there was a pleasant rapport between the people who live at the home the manager and staff. The staff said that they have found the manager to be approachable and supportive even though she had only been in post for two weeks. One person said, The manager seems really nice. Staff said that they liked working at the home. Some staff said that they hope to get more support from the new manager. Care Homes for Older People Page 22 of 27 Evidence: The manager said that staff have individual supervision. Records showed and staff said that they were not receiving them as often as they should. A staff meeting had been planned by the manager for the next day. The home has procedures for staff when they deal with the peoples money so it is kept safe. Records showed that manager checks them regularly. The manager said that the money is checked regularly and every transaction is signed by two people. Records showed that fire drills have taken place when they should however did not confirm that fire instruction had been taking place. Staff said that they did have fire drills and fire instruction. Electrical equipment through the home had been safety checked. The manager said that the home does have a quality assurance system but it needs to developed and up dated. They intend to use information collected in the home to improve the service. The manager said that the annual development plan for the home is going to worked on. Care Homes for Older People Page 23 of 27 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 27 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 1 18 18 Staff must be trained in 31/01/2009 adult safeguarding procedures and the homes whistle blowing policy so they will recognise and know how to make an alert. Staff must have the required training so they will recognise when to make an alert and thus safeguard the people at the home. 2 29 19 The registered person must obtain the information and documents specified in 1 to 7 in Schedule 2. Gaps in applicants work history should be examined during the recruitment process and the reasons for the gaps in work history to safeguard the people at the home. 31/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards Care Homes for Older People Page 25 of 27 and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 All care plans are up to date and accurate and they are reviewed every month. They also contain all areas such as social interests,hobbies,family involvement nd social contacts. The arrangements for the storage of medication should be reviewed. The arrangements for health and personal care make sure that the persons privacy and dignity are respected at all times. The repairs to the bathrooms should be carried out and the bed repaired or replaced in bedroom 17. The manager should review staffing levels to make sure their are enough staff on duty to meet the assessed needs of the people who live at the home. That 50 of staff have vocational qualifications. Staff should receive individual formal supervision at the required intervals To make sure staff receive fire instruction at the required intervals. 2 3 9 10 4 5 19 27 6 7 8 28 36 38 Care Homes for Older People Page 26 of 27 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 27 of 27 - 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!