CARE HOMES FOR OLDER PEOPLE
Delapre House 109 Magna Road Bearwood Poole Dorset BH11 9NE Lead Inspector
Debra Jones Unannounced Inspection 2nd November 2005 10:40 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 Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Delapre House Address 109 Magna Road Bearwood Poole Dorset BH11 9NE 01202 570800 01202 570800 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) Bell Social Work Ltd (BSW Ltd) Miss Judith Bell Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: Delapre House is registered to provide accommodation for ten older people in an attractive converted house. It is set back from a main road on the northern borders of Bournemouth and Poole. Local bus services provide easy access to the town centres and Wimborne. The home has some car parking at the front and plenty of on road car parking is available. There is a large well-maintained garden to the rear. The accommodation for residents in the home is over the ground and 1st floors with a passenger lift between. There are a variety of aids and adaptations around the building to allow residents to move about more independently. There are 10 single rooms all of which have en suite facilities. There are additional communal toilets and bathrooms around the home. Situated on the ground floor is the service users lounge, which overlooks the garden. An archway leads into the dining area. There is also a small quiet lounge that also overlooks the garden. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 2 and half hours and was the second of the two anticipated inspections of the year. The 7 requirements and one recommendation made at the last inspection were followed up to see if there had been any progress made towards meeting them. All but one requirement had been met and only one further recommendation was made. During the inspection a number of records were looked at. The Inspector walked around some of the building and met and chatted with residents in the lounge who all spoke positively about the home ‘staff are very kind and caring’ ‘It’s lovely.’ Ms Bell – the Proprietor / Manager assisted the Inspector in her work. Prior to the inspection the Commission asked the home to send out a number of comment cards to get people’s views of the home. 13 were returned. 4 were from residents, 1 was from a Health and Social Care Professional, 1 from a Care Manager, 2 from General Practitioners, and 5 from relatives. The majority returned were very positive about the staff and service provided at the home. The few negative comments were discussed and appeared to be related to issues that had since been resolved. ‘My client has significant sensory loss and the staff have done all they can to minimise the isolation that could be experienced by her – very satisfied.’ - care manager ‘Generally the care given is of a high standard’- health and social care professional What the service does well:
Delapre House aims to provide a family atmosphere and does so successfully in a house decorated and furnished in a homely way. The home is well organised and the care and contentment of residents is at the heart of the way the home is run. Medication is well managed and residents can have confidence that staff look after their medicines well and administer them properly. Residents are well cared for and treated with respect and dignity and are able to exercise choice and control over their lives. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 6 Information is available with training and systems in place at the home to ensure that residents are protected from abuse. Staff are well trained ensuring that residents needs are met and that they are well cared for. What has improved since the last inspection? What they could do better:
The home is yet to carry out a survey to find out what people think about the home in order to improve services for the residents. It would be good if when a number of responses have been received the home pulled them together and wrote a report about what they have found out and what, if anything, they might do about it. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 7 The adult protection policy should be updated to include information about the Protection of Vulnerable Adults list e.g. how it is checked before anyone starts working at the home and that staff that prove to be unsuitable to work with older people can be referred to it. 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. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 8 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 Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 9 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): 4 (Standards 1,2,3 and 5 were met at the last inspection) Prospective residents get the necessary assurance that their needs can be met at the home. EVIDENCE: A resident who had recently moved into the home talked very positively about her experiences in visiting and moving into Delapre House, and about the homely, relaxed and friendly atmosphere. Records confirmed that the assessed ability for the home to provide care had been confirmed in writing to this resident. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 and 10 (Standards 7 and 8 were met at the last inspection) The medication at this home is generally well managed, promoting the good health and well being of residents. Residents confirmed that they were treated with dignity and that their privacy was respected. EVIDENCE: A robust system for the ordering, administering and recording of medication is in place at the home. The medication policy has recently been reviewed and expanded. Patient information leaflets are available in the home about the medication in use. Medication at the home is only administered by the proprietor / manager and experienced staff who are all confident in carrying out this task. Medication records sampled were up to date and well completed, matching the medicines in the home. Staff properly record the date that medicines are opened/ brought into use when they are not in the blister packs. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 11 Medicines were tidily stored in the medication cupboards. The maximum and minimum temperature of the fridge used to store medication is currently monitored. Only eye drops are being stored there at present. One resident asked about medication expressed confidence in the way that the home handled this aspect of her care. 4 residents returned comment cards to the Commission prior to the inspection. All said that they felt well cared for, that staff treated them well and that their privacy was respected. This was confirmed by the residents spoken to on the day of inspection. Staff are introduced to the principles of promoting privacy and dignity in their induction. It is also referred to in their job descriptions and in the staff handbook. Staff were seen to be treating residents in a respectful and dignified way during the course of the inspection. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 (Standards 12, 13 and 15 were met at the last inspection) Residents are helped and encouraged to exercise choice in their daily lives at the home. EVIDENCE: Most residents at the home are able to express their likes and dislikes and spend their days as they choose. Residents talked with the Inspector about how they liked to spend their days and of how the staff supported them to do as they wished. Staff are clear that Delapre House is the home of the residents and they are there to support them to lead the lives they wish. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 (Standard 16 was met at the last inspection) The home’s adult protection policy and staff training in this area demonstrates the homes commitment to understanding abuse and of protecting the residents in their care. EVIDENCE: The home’s adult protection policy demonstrates an understanding of abuse and of how residents are protected, but needs updating in light of the Protection of Vulnerable Adults list. Staff receive training in this area as part of their induction. All staff at the home have had this training in the last year. The 4 residents who returned comment cards to the Commission confirmed that they felt safe living at the home. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 (Standards 19,21,23,24,25 and 26 were met at the last inspection) The home is suitable for the residents living there. EVIDENCE: Since the last inspection the premises have been assessed by an Occupational Therapist. Their report confirmed that the home is suitable for older people and no requirements were made in respect of securing any further disability equipment or having to adapt the environment in any way at present. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 15 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, 29 and 30 (Standard 28 was met at the last inspection) Sufficient well-trained care staff are employed and deployed at the home to ensure that the care needs of residents can be met. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. EVIDENCE: Staffing rosters are in place that show who is on duty and when. Rosters now include all staff on duty- not just care staff, their full names and their designations i.e. what job they do. At the last inspection a few gaps were found in the documentation that must be obtained for staff employed at the home. This was in respect of evidence being held of CRB disclosures and POVA 1st checks. Proof of the outcome of these checks is now being obtained and kept. Training is taken seriously at the home. Staff mostly either have or are studying for National Vocational Qualifications. In addition staff are properly and thoroughly inducted and have access to other training courses relevant to their work e.g. food hygiene, infection control, handling of medication. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 16 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): 33, 37 and 38 (Standards 31,35,and 36 were met at the last inspection) The health, safety and welfare of residents along with their rights and best interests are promoted and safeguarded by the way the home is conducted. Whilst there is nothing to demonstrate that the home is not run in the best interests of residents the quality assurance system has not been fully implemented yet. EVIDENCE: The home opened in October 2004 and is yet to carry out their annual quality assurance survey to find out what people think about the home. When it is done later this year a report will be written based on the analysis of the results of the survey. This report can then be circulated to any interested parties. All records kept in the home were made available to the inspector as requested and are appropriately stored.
Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 17 An up to date insurance certificate was on display along with Delapre House’s registration certificate. Both pages of this certificate are now displayed. Fire records were in place. Checks are being carried out by the home to ensure that their fire equipment works and records are kept showing that this is being appropriately done at regular weekly and monthly intervals. Fire training, fire drills and fire evacuations are taking place. Fire training records for staff are now easy to follow and it can be seen at a glance when individual staff last had fire training and when it is next due. Certificates are issued by the trainer that confirms the attendance of staff. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 18 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 x 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 x x x 3 x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x x x 3 3 Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP33 Regulation 24 Requirement A system of reviewing and improving the quality of care at the home must be established and maintained. Timescale for action 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP18 Good Practice Recommendations The adult protection policy should be updated to include information about the Protection of Vulnerable Adults list e.g. how it is checked before anyone starts working at the home and that staff that prove to be unsuitable to work with older people can be referred to it. Delapre House DS0000061562.V263647.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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